What are the key clinical signs and symptoms to recognize compartment syndrome in a patient presenting with limb pain?

Key clinical signs and symptoms to recognize compartment syndrome in a patient presenting with limb pain include:

• Severe pain disproportionate to the injury that is persistent and worsens despite analgesia, often described as deep and burning in nature NICE NG37 Frink et al. 2010.
• Pain on passive stretch of the muscles within the affected compartment, which is an early and sensitive clinical indicator NICE NG37 Frink et al. 2010.
• Tense, swollen compartment on palpation, indicating increased intracompartmental pressure NICE NG37 Frink et al. 2010.
• Paresthesia or sensory deficits in the distribution of nerves passing through the compartment, reflecting early nerve ischemia NICE NG37 Frink et al. 2010.
• Muscle weakness or paralysis may develop as the syndrome progresses, indicating muscle and nerve compromise NICE NG37 Frink et al. 2010.
• Pallor and pulselessness are late signs and may indicate vascular compromise; however, pulses can be present early in compartment syndrome and their absence is not required for diagnosis NICE NG37 Frink et al. 2010.

Early recognition relies heavily on clinical assessment focusing on pain characteristics and neurological symptoms, as compartment pressure measurement is not always immediately available or definitive NICE NG37 Frink et al. 2010. Prompt diagnosis and surgical intervention are critical to prevent permanent tissue damage.