The following is the summary of “Point of care ultrasound needle guidance to assist diagnosis of acute gluteal compartment syndrome” published in the December 2022 issue of Emergency medicine by Puebla, et al.

When compared to other fascial compartments, the gluteal compartments can be more challenging to evaluate for acute compartment syndrome (ACS) due to the structure of these compartments and the rarity of their presentation. Using point-of-care ultrasound (POCUS) needle guiding can help get more precise readings of the pressure inside the gluteal compartments.

Researchers discuss the case of a 69-year-old woman who sought medical attention after sustaining a dislocation of her superior prosthetic hip due to a fall. After having her hip reduced, the patient began to have acute discomfort in her right leg, as well as swelling in her gluteal region and numbness in her foot one hour after the procedure. POCUS was utilized to direct the needle of a compartmental pressure monitor system into the gluteal maximus and medius-minimus compartments, which indicated higher compartment pressures compatible with ACS. 

This was done with the development of gluteal compartment syndrome in mind. After that, the patient was sent to receive an emergency fasciotomy and hematoma evacuation. Comparing a palpation or landmark-guided technique to US guidance for measuring compartment pressure, there has been just a small amount of research done on this topic. This example demonstrates that it is possible to use US needle guidance when examining compartment pressures for a diagnosis that is somewhat unusual.

Source: sciencedirect.com/science/article/abs/pii/S0735675722005770