PURPOSE Acute compartment syndrome is a condition whereby tissue ischaemia occurs due to increased pressure in a closed myofascial compartment. It is a surgical emergency, with rapid recognition and treatment-the keys to good outcomes. METHODS The available literature on diagnostic aids was reviewed by one of the senior authors 15 years ago. Now, we have further reviewed the literature, to aim to ascertain what progress has been made. RESULTS In this review, we present the evidence around a variety of available diagnostic options when investigating a potential case of acute compartment syndrome, including those looking at pressure changes, localised oxygenation, perfusion, metabolic changes and available blood serum biomarkers. CONCLUSIONS A significant amount of work has been put into developing modalities of diagnosis for acute compartment syndrome in the last 15 years. There is a lot of promising outcomes being reported; however, there is yet to be any conclusive evidence to suggest that they should be used over intracompartmental pressure measurement, which remains the gold standard. However, clinicians should be cognizant that compartment pressure monitoring lacks diagnostic specificity, and could lead to unnecessary fasciotomy when used as the sole criterion for diagnosis. Therefore, pressure monitoring is ideally used in situations where clinical suspicion is raised.

中文翻译：

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诊断急性室综合征-我们要去哪里？

目的急性室综合征是指由于封闭的肌筋膜室中压力增加而发生组织缺血的疾病。这是外科急症，具有快速的识别和治疗-取得良好效果的关键。方法15年前的一位资深作者回顾了有关诊断辅助工具的现有文献。现在，我们进一步回顾了文献，旨在确定取得了哪些进展。结果在本综述中，我们在调查急性区室综合征的潜在病例时，提供了围绕各种可用诊断选项的证据，包括那些研究压力变化，局部氧合，灌注，代谢变化和可用血清生物标志物的病例。结论在过去的15年中，已经开展了大量工作来开发诊断急性室综合征的方法。据报道有很多有希望的结果。但是，尚无确凿证据表明应将其用于隔室压力测量，这仍然是金标准。但是，临床医生应意识到隔室压力监测缺乏诊断特异性，当用作诊断的唯一标准时可能会导致不必要的筋膜切开术。因此，理想的情况是在引起临床怀疑的情况下使用压力监测。尚无任何确凿证据表明应将其用于房内压力测量，这仍然是金标准。但是，临床医生应意识到隔室压力监测缺乏诊断特异性，当用作诊断的唯一标准时可能会导致不必要的筋膜切开术。因此，理想的情况是在引起临床怀疑的情况下使用压力监测。尚无任何确凿证据表明应将其用于房内压力测量，这仍然是金标准。但是，临床医生应意识到隔室压力监测缺乏诊断特异性，当用作诊断的唯一标准时可能会导致不必要的筋膜切开术。因此，理想的情况是在引起临床怀疑的情况下使用压力监测。