Chronic Compartment Syndrome treatment in Portland Oregon?

May 13, 2015 7:30 PM

Looking for a physician in Portland, OR area to diagnose and treat chronic exertional compartment syndrome.

My partner has been tentatively diagnosed with chronic exertional compartment syndrome. From reading previous AskMeFi's and the Mayo Clinic website, it looks like the gold standard for diagnosis is a pressure test and treatment consists of fasciotomy surgery.

Does anyone have any experience with doctors in the Portland, Oregon area who are experienced in treating this condition? We will, of course, consult both our PCP's, but she has been trying to get this problem fixed for two years and just recently came across an osteopath who suggested the problem may be CECS. The fact that previous doctors (including an orthopedic surgeon) didn't suggest this as a cause of her leg pain makes me think that the condition is uncommon.

Even the type of specialist to try to find would be a useful lead.

posted by elmay to Health & Fitness (3 answers total)

An orthopedist. They are the ones who deal with compartment syndrome and they know how to check compartment pressures. It's a simple procedure (although a little invasive because a needle has to go into the compartment) and you could have your answer in 5 minutes. Or at least the orthopedist could tell you why the osteopath's idea is wrong/not worth pursuing.
posted by treehorn+bunny at 7:44 PM on May 13, 2015 [1 favorite]

And just to be clear, because I'm not sure it is very clear to folks without a medical background, but even though osteopaths and orthopedists/orthopedic surgeons may sound similar (the word roots both boil down to bone doctors, right?), they are not similar at all in their training.

Osteopathic medical school is an alternative to traditional allopathic medical school - both 4 year programs that earn you the right to practice medicine, as a D.O. or M.D. respectively. D.O.s tend to go into primary care and generally speaking, aren't able to compete as well for selective residency programs. D.O. school is very similar to allopathic medical school except that osteopaths are trained in osteopathic manipulation, which many believe to be pseudoscience (including many osteopaths I know).

Orthopedists, on the other hand, may be osteopaths as well but are usually MDs, and they have a 5 year long residency and often fellowship training beyond medical school in the musculoskeletal system and in surgery related to it. It's one of the most competitive specialties that tends to attract some of the top performing medical students in the country. So I am not saying that the orthopedist is right and the osteopath is wrong, I have no idea of the value of either of their opinions per se, but this background knowledge made me more skeptical of your osteopath's opinion.
posted by treehorn+bunny at 7:55 PM on May 13, 2015 [4 favorites]

I would probably start with the sports medicine practice at OHSU, since it seems like the diagnosis is made using measurements of compartment pressure before and after exercise, and you would need a facility that is capable of doing those measurements. I have no idea if they're able to do that there or not, but in my experience academic medical centers are more likely to have that kind of lab. If she ends up having it, they will be able to hook her up with an orthopedist very easily.
posted by The Elusive Architeuthis at 8:44 AM on May 14, 2015