Chronic legs stress syndromes.

Topics - The chronic stress syndrome can be defined as a state in which an intramuscular increase in pressure in a limited space (osteo-aponevrotic compartment) compromises the circulation and the function of muscular and nervous tissues located inside this space. For anatomic reasons, the anterior and lateral aspect of the leg of the young and sporting subject is more often affected than the posterior compartment, The other localizations of the leg and those interesting the arm are less frequent but are still underestimated. The clinical and differential diagnosis rests on: a predisposing ground (pathology of overuse); a characteristic pain (topography, evolution); a normal clinical examination at rest. The diagnosis is confirmed by the measurement of the intramuscular pressures above a critical point during the effort, but also by a too slow return to the pressures of rest after stop of the effort. The advantage of the other complementary examinations, aside the bon scan or else the RMN, is to eliminate the differential diagnoses. Conclusion - The treatment of a chronic stress syndrome is above all surgical for the medical treatments cannot make completely disappear the existence of a painful threshold to the effort. The surgical treatment by sub cutaneous aponevrotomy or aponevrectomy is the rule in the sportsman eager to continue his activity with approximately 90% good results. (C) 2001 Editions scientifiques et medicales Elsevier SAS.