Clinical Features

Signs and symptoms of ACS typically progress rapidly over a few hours but the presentation and onset are highly variable.

• Pain out of proportion to the extent of apparent injury

  • Worsens with passive stretching or extension of muscles

  • Extreme tenderness to touch

• Soft tissue swelling

• Tight, wood-like muscles

• Neurologic deficits

  • Paresthesia (e.g., pins and needles sensation)

  • Sensory deficits

  • Muscle weakness or paralysis

• Impaired perfusion

  • Cold extremity with pallor or cyanosis (uncommon)

  • Absent or weak distal pulses