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Problem Statement
Problem Statement
Due to the time sensitivity, user-dependence, and extreme physical discomfort associated with diagnosing chronic exertional compartment syndrome (CECS) using intracompartmental pressure testing, sports medicine physicians and people who are undergoing compartment pressure testing need a less painful, non-invasive, and more efficient diagnostic method.
Due to the time sensitivity, user-dependence, and extreme physical discomfort associated with diagnosing chronic exertional compartment syndrome (CECS) using intracompartmental pressure testing, sports medicine physicians and people who are undergoing compartment pressure testing need a less painful, non-invasive, and more efficient diagnostic method.
Disease background: Chronic Exertional Compartment Syndrome
Disease background: Chronic Exertional Compartment Syndrome
Chronic exertional compartment syndrome is a pathological condition characterized by increased pressure in one or more compartments of the lower leg, usually in response to swelling or injury of the muscle tissue (OrthoInfo). Compartments are groups of muscles, nerves, and blood vessels surrounded by fascia. Fascia, a tough collagenous membrane, does not stretch, and this lack of elasticity causes the increased pressure in the compartment when the swelling occurs. The high pressure can disrupt blood flow to the muscles and nerve cells, which can cause them damage due to prolonged lack of oxygen and nutrients.
Diagnostic Method: Intracompartmental needle manometry
Diagnostic Method: Intracompartmental needle manometry
Procedure involves inserting a needle into compartment, injecting saline solution, and measuring pressure created by resistance of muscle against the injected solution before and after exercise (MayoClinic). Affected compartments experience elevated post-exercise pressure levels because the fascia restrict muscle expansion.
Devices used:
Compass Compartment Pressure Monitoring Kit: one-time use product that digitally displays the pressure measurement
Stryker Pressure Monitor System: uses replaceable syringe implementation
Problems with Intracompartmental needle manometry
Problems with Intracompartmental needle manometry
Extremely painful: inject each compartment in each leg before and after exercise with a 16-18 gauge needle without use of local anesthetics
Results depend on the doctor administering the test: interpretation of results can vary from doctor to doctor
Highly time-sensitive: pressure in compartment starts dropping as soon as patient stops exercising, so accuracy of measurement decreases with time
The hassle of the diagnostic procedure for CECS is partially responsible for the fact that the disease widely underdiagnosed (Buerba et al)
Other Technologies
Other Technologies
Slit catheters: a catheter with a tip consisting of sensitive transducers is inserted into the target muscle compartment, the transducers measure intracompartmental pressure
Catheter insertion is slow, making measurements inaccurate
Near-infrared spectroscopy measures oxygen saturation in hemoglobin
Currently not sensitive enough to differentiate between those with and without CECS
Magnetic resonance imaging (MRI) uses image intensity (brightness of tissue) to determine pressure differences
Quality and accuracy of data unreliable
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