Restricted

A 27 year old man presents with pain in the right calf for one day, and swelling of the same area since morning.

The pain started abruptly while he was playing football last evening. There was no history of trauma.

He obtained a medical consultation, at which he was prescribed analgesics and sent home. However, the pain worsened over time, and is now severe and present at rest.

His medical history is unremarkable.

Select Relevant Investigations
Renal functions

Performed

Urea: 13 mg/dL (0 - 50)
S. Creatinine: 1.0 mg/dL (0.5 - 1.5)
Creatine Kinase

Performed

10,800 IU/L (45 - 245)
Measure Compartment Pressures

Performed

Pressure in compartments of right leg:
Anterior: 30 mmHg
Lateral: 70 mmHg
Deep & Superficial Posterior: 100 mmHg
MRI Right Leg

Performed

There is widespread muscle edema in all four compartments. A large hematoma is noted within the body of the gastrocnemius muscle.

Select Relevant Management
Emergency Fasciotomy
IV Fluids
IV Antibiotics
NSAIDs