From the Guidelines
Deltoid compartment syndrome is characterized by symptoms including severe, persistent pain in the shoulder, pain that worsens with passive stretching of the deltoid muscle, and significant swelling or tightness in the shoulder region, as reported in recent studies 1. The symptoms of deltoid compartment syndrome can be attributed to the increased pressure within the deltoid muscle compartment, leading to tissue damage and nerve irritation.
- Severe, persistent pain in the shoulder that is disproportionate to the injury is a common symptom, as noted in the study by 1.
- Pain that worsens with passive stretching of the deltoid muscle is also a significant indicator, as mentioned in the guidelines for the acute care of severe limb trauma patients 1.
- Significant swelling or tightness in the shoulder region can be observed, and patients may experience weakness in shoulder movement, numbness or tingling in the affected area, and a firm, wooden feeling of the deltoid muscle upon palpation, as described in the study 1. In advanced cases, there may be decreased pulses in the affected limb, pale or shiny skin over the shoulder, and even paralysis of the affected muscle, highlighting the importance of early recognition and treatment to prevent permanent disability, muscle necrosis, and loss of shoulder function, as emphasized in the study 1. The presence of both severe pain and pain on passive stretch of the affected muscle compartment gives a positive predictive value of 68%, as reported in the study 1, making these symptoms crucial for early diagnosis and intervention.
From the Research
Symptoms of Deltoid Compartment Syndrome
The symptoms of deltoid compartment syndrome include:
- Pain, which can be slow in onset 2
- Swelling of the affected area 2
- Decreased sensation to light touch 2
- Decreased range of motion 2
- Coolness to touch with decreased pulses 2
- Pain out of proportion to the injury, which is a classical description of acute compartment syndrome 3
Clinical Presentation
Deltoid compartment syndrome can present with additional symptoms such as:
- Isolated deltoid involvement, often resulting from iatrogenic injury 4
- Involvement of other compartments, most commonly in the ipsilateral arm 4
- Prolonged recumbence owing to substance abuse 4
- Delayed onset of symptoms, as seen in a case of delayed deltoid compartment syndrome after resuscitation via humeral intraosseous access 5
Diagnosis and Treatment
Diagnosis of deltoid compartment syndrome is largely clinical, with compartment pressure monitors used as a helpful adjunct where the diagnosis is in doubt 3. Treatment involves timely surgical decompression of all the involved compartments to relieve intra-compartmental pressure 4, 5, 2, 6, 3