Disclosures: Amy D. Hiller, DO: No financial relationships or conflicts of interest

Case Description: The patient had progressive, severe pain in the emergency department and was admitted to the hospital for hydration with CK of 8400 U/L [37-289]. TSH was 694 IU/mL [0.4-4.0]. Upon further questioning, there was no change in activity including vigorous exercise, trauma, or recent illness.

Setting: Tertiary care pediatric hospital

Patient: 16 year-old male with five day history of progressive bilateral leg pain and dark urine in setting of type I diabetes and hypothyroidism. Assessment/

Results: While still unknown, the etiology of his compartment syndrome was presumed to be related to his diabetes or hypothyroidism. Given available published cases, idiopathic is likely.

Discussion: This is a case of bilateral spontaneous non-traumatic compartment syndrome. Given rarity of the event, a literature review was performed and found few published case reports of non-traumatic compartment syndrome in the absence of bleeding or anti-coagulation therapy, let alone in the pediatric population. Some cases were found in those with hypothyroidism or diabetes mellitus but none were bilateral.

Conclusion: Non-traumatic spontaneous compartment syndrome can occur with comorbidities other than bleeding or concomitant anti-coagulation therapy. Inciting factors are unknown however consequences come with clear short and long term rehabilitation needs. Given the consequences of this case, it is prudent to keep non-traumatic compartment syndrome on a differential for atraumatic leg pain, which is not uncommon for any physiatrist to evaluate.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/bilateral-spontaneous-non-traumatic-compartment-syndrome-in-adolescent-male/