Chronic exertional compartment syndrome in the differential diagnosis of peripheral artery disease in older patients with exercise-induced lower limb pain

Johan A. de Bruijn*, Kim C. A. Wijns, Sander M. J. van Kuijk, Adwin R. Hoogeveen, Joep A. W. Teijink, Marc R. M. Scheltinga

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objective: Peripheral artery disease (PAD) and chronic exertional compartment syndrome (CECS) both cause exercise-induced lower limb pain. CECS is mostly described in young individuals and may therefore not be considered in older patients with intermittent claudication. The aim of our study was to identify differences in characteristics and symptomatology between patients with CECS and PAD that may help in recognizing CECS in patients >= 50 years with exercise-induced lower limb pain.

Methods: In this case-control study, patients with CECS >= 50 years were selected from a prospectively followed cohort and compared with a sample of newly diagnosed patients with PAD >= 50 years. A questionnaire assessed frequency and severity of lower limb pain, tightness, cramps, muscle weakness, and altered skin sensation at rest and during exercise.

Results: At rest, patients with CECS (n = 43, 42% female, 57 years; range, 50-76 years) reported significantly more pain, tightness, muscle weakness and altered skin sensation (all P

Conclusions: Patients with CECS >= 50 years report a symptom pattern that is different from patients with PAD. These differences may aid vascular surgeons in identifying older patients with CECS.

Original languageEnglish
Pages (from-to)2114-2121
Number of pages8
JournalJournal of Vascular Surgery
Issue number6
Publication statusPublished - Jun 2021


  • Intermittent claudication
  • Peripheral artery disease
  • Chronic exertional compartment syndrome
  • Older patients

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