How is the progression of clinical signs?
Signs and symptoms of ACS typically progress rapidly over a few hours but the presentation and onset are highly variable.
List early features.
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
List later features.
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
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