Acute exertional medial compartment syndrome of the foot after playing basketball

Compartment syndrome of the foot is an uncommon event. The most common cause of compartment syndrome of the foot is a crush injury. Exceedingly rare is acute compartment syndrome of the foot occurring in the absence of trauma. We describe the clinical scenario involving a 23-year-old healthy male who developed acute exertional compartment syndrome isolated to the medial compartment of the foot after playing basketball. The patient had no evidence of injury nor trauma, and the diagnosis was made based on physical exam, magnetic resonance imaging (MRI), and compartment pressure measurements. The patient did undergo successful fasciotomy on the day of presentation to the emergency department and has since completely recovered. We found four cases reported in the literature of acute exertional medial compartment syndrome of the foot in the absence of trauma or injury. This is the second case reported after playing basketball, while the others occurred after aerobics, a long distance run, and football. The most recent case was reported by Miozzari et al. [Am J Sports Med. 36(5):983-6, 2008] and involved a marathon runner who developed an isolated medial compartment syndrome of the foot. We would like to increase awareness of this uncommon clinical presentation in the absence of trauma and present the dramatic radiographic findings.