Ultra Skinny Jeans

By Elia Petzierides

Calling all hipsters, fashionistas and wearers of ultra skinny jeans: this is a serious health warning.

Hipsters like to consider themselves to be leaders of the latest cultural trends. But when a 35-year-old woman presented to the Royal Adelaide Hospital with an inability to walk, swelling and weakness to both legs she became the first person documented in medical literature to display nerve dysfunction as a result of wearing tight jeans. So what happened to this hipster pioneer whose fashion breached the human body’s physiological limits and what can be done to prevent other hipsters from suffering the same ignominy?

The Royal Adelaide Hospital is located in the heart of Adelaide, a South Australian city trying to make its mark on the fashion map, and it is here where the the 35-year-old female presented. The ultra skinny jeans were so tight they caused:

an inability to walk
bilateral markedly oedematous (swollen) lower legs
bilateral severe ankle weakness
impaired sensation to the lateral aspects (outer sides) of both lower legs and the dorsum (top) of both feet.

On the plus side, her:

peripheral pulses were normal
both feet were warm and well perfused (good blood flow)

A history of the presenting complaint was obtained and revealed the patient had been helping a friend move house which involved prolonged and repeated squatting while wearing a pair of skinny jeans which she described as becoming increasingly tight throughout the day. That evening while walking home she experienced bilateral foot drop (dropping of the forefoot) and numbness in her feet which were blamed for her tripping and falling. After spending several hours on the ground unable to walk she was found and taken to hospital.

Investigations at hospital revealed:

a markedly elevated creatinine kinase (73215 IU/L)
normal renal function
CT scan of lower legs showed pronounced oedema and hypoattenuation (reduction in density) of the posterior (back) of both calf muscles
nerve conduction studies revealed a conduction block in both peroneal nerves (located in lower leg)

The following diagnoses were made:

bilateral peroneal and tibial nerve neuropathies (dysfunction of nerves in lower leg causing altered sensation and weakness)
rhabdomyolysis (muscle breakdown as a result of muscle damage which can result in death if left untreated)

The woman was treated with intravenous hydration and removal of the offending jeans. So tight were the jeans that the only way they could be removed was to cut them off. The oedema and neurological function improved greatly and after four days in hospital the 35-year-old was able to walk again unassisted and was discharged home alive and well.

Presumably as a result of the popularity of skinny jeans the neurologist and co-author of the case study Associate Professor Thomas Kimber listed the following tips in an interview with the ABC to prevent hipsters and fashionistas from suffering a similar fate:

Wear appropriate clothes for the task.
Looser clothing with elasticity will let muscles expand.
If altered sensation such as tingling is noticed while squatting, get up and walk around.

So there you have it folks – not too tight with the jeans, don’t fear a little elasticity in your denim and if you notice tingling while squatting, get up and go for a walk. And remember, fashion trends may come and go, but nerve damage is forever.

The author Elia Petzierides is a Victorian based Advanced Life Support Paramedic and Registered Nurse with a Graduate Diploma in Advanced Clinical Nursing.

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