Which finding is the earliest sign of compartment syndrome?

Which finding is the earliest sign of compartment syndrome?

• A. Pain with passive stretch of the muscle
• B. Swelling of the affected extremity
• C. Paresthesias and loss of function
• D. Pain out of proportion to the injury

Answer: (A)

Compartment syndrome arises when intracompartmental pressure rises enough to impair tissue perfusion within a closed fascial space. The earliest sign you’re likely to detect is pain triggered by passive stretching of the affected muscle. Stretching lengthens the muscle inside the confined space, increasing pressure on ischemic nerve endings and producing sharp, intense pain that seems disproportionate to the injury. Swelling, numbness (paresthesias), and weakness tend to appear later as perfusion worsens and nerves and muscles become increasingly deprived of blood. While pain out of proportion to the injury is a key warning sign, the passive-stretch pain is typically the first measurable cue clinicians rely on to recognize evolving compartment syndrome.

Compartment syndrome arises when intracompartmental pressure rises enough to impair tissue perfusion within a closed fascial space. The earliest sign you’re likely to detect is pain triggered by passive stretching of the affected muscle. Stretching lengthens the muscle inside the confined space, increasing pressure on ischemic nerve endings and producing sharp, intense pain that seems disproportionate to the injury. Swelling, numbness (paresthesias), and weakness tend to appear later as perfusion worsens and nerves and muscles become increasingly deprived of blood. While pain out of proportion to the injury is a key warning sign, the passive-stretch pain is typically the first measurable cue clinicians rely on to recognize evolving compartment syndrome.