Acute compartment syndrome (ACS) is an emergency. The majority of cases are caused by underlying trauma, especially fractures. Idiopathic atraumatic ACS of the leg is very rare. The diagnosis and management of ACS should focus on the clinical presentation to avoid delay in fasciotomy for limb salvage. ACS of the leg can be caused by massive proximal iliofemoral thrombosis and rarely occlusive popliteal vein thrombosis with total or near total occlusion. Nonocclusive distal popliteal vein thrombosis, especially if chronic, does not cause ACS and when seen in a patient with ACS, it is likely an incidental finding rather than the cause of the compartment syndrome. This is a case of idiopathic ACS of the right leg occurring in the presence of an incidental right chronic nonocclusive distal popliteal vein thrombosis.
Keywords: acute compartment syndrome; acute extremity compartment syndrome; anticoagulation; deep vein thrombosis; fasciotomy; idiopathic acute compartment syndrome; spontaneous acute compartment syndrome.