By Elia Petzierides
Calling all hipsters, fashionistas and wearers of ultra skinny jeans: this is a serious health warning.
- 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.
- 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)
- 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.
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