Lumbar paraspinal compartment syndrome with concomitant rhabdomyolysis and multifidus necrosis.
Valentina A Kucher, Adam R Sahlberg, Cheryl L Miller
✦ AI-curated · Sources linked
Case in brief
A 29-year-old male presented to the emergency department with acute low back pain after playing touch football. Initially discharged with a diagnosis of muscle spasm, he returned 24 hours later with severe pain and elevated creatine kinase levels indicating rhabdomyolysis. MRI showed edema in the left paraspinal muscles, leading to emergent surgical decompression, which confirmed multifidus necrosis.
What made this case unusual
The case exemplifies a bounce-back presentation, where initial misdiagnosis led to a critical delay in treatment for a rare condition.
Diagnostic / clinical pearl
Clinicians should be vigilant for disproportionate pain and unexplained rhabdomyolysis, as these may indicate acute lumbar paraspinal compartment syndrome requiring urgent intervention.
Why it matters
Recognizing the signs of compartment syndrome early can prevent severe complications such as irreversible myonecrosis and acute kidney injury.