Tests and diagnosis
By Mayo Clinic staffOther exercise-related problems are more common than chronic exertional compartment syndrome, so your doctor may first try to rule out other causes — such as shin splints or stress fractures — before moving on to more specialized testing.
Physical exams for chronic exertional compartment syndrome are often normal. Your doctor may prefer to examine you after you've exercised, when the condition is more likely to be apparent. Your doctor may notice a muscle bulge (herniation), tenderness or tension in the affected area.
Imaging studies
Your doctor may suggest that you have imaging studies done, such as magnetic resonance imaging (MRI) or near infrared spectroscopy (NIRS). A typical MRI scan of your legs can be used to evaluate the structure of the muscles in the compartments and rule out other possible causes of your symptoms. NIRS is a newer technique that uses light wavelengths to measure tissue oxygen saturation in your blood. This helps to determine if your muscle compartment has decreased blood flow. Both techniques have had good results in noninvasively diagnosing chronic exertional compartment syndrome.
Compartment pressure testing
If imaging studies fail to uncover an abnormality like a stress fracture or similar cause of pain, your doctor may suggest measuring the pressure within your muscle compartments.
This test, often called compartment pressure measurement, is the gold standard for diagnosing chronic exertional compartment syndrome. Because it's invasive and mildly painful, involving insertion of needles into your muscles, compartment pressure measurement usually isn't performed unless your medical history and other tests strongly suggest you may have this condition.
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