A prospective blinded evaluation of exercise thallium-201 SPET in patientswith suspected chronic exertional compartment syndrome of the leg

This study compared the quantitative and qualitative results of leg thalliu m-201 single-photon emission tomography (SPET) imaging in patients with and without raised intracompartmental pressure associated with exercise-relate d leg pain. The purpose of this study was to clarify the aetiology of chron ic exertional compartment syndrome (CECS), and to investigate the diagnosti c applications of (TI)-T-201 SPET in CECS. Thirty-four study participants u nderwent compartment pressure testing (CPT) between March and August 2000. There were 25 positive CPT results (patient group), and nine negative CPT r esults (control group). All 34 participants underwent scintigraphy. Quantit ative and qualitative assessments were performed for the anterolateral and deep posterior compartments of the lower leg. There was no significant diff erence in either quantitative or qualitative assessments of perfusion betwe en those compartments with and those without CECS. In contrast, a marked ef fect of exercise type upon compartment perfusion pattern was noted. Results of this study indicate that there is no compartment perfusion deficit in t hose patients with raised intracompartmental pressure associated with CECS, and suggest a non-ischaemic basis for the pain associated with CECS. They also suggest no role for exercise perfusion scintigraphy in the diagnosis o f this syndrome.