Advanced Trauma Life Support (ATLS) Practice Exam 2025 - Free ATLS Practice Questions and Study Guide

Pain out of proportion is a hallmark clinical indicator of compartment syndrome in extremities. This condition occurs when there is increased pressure within a muscle compartment that compromises circulation and function of the tissues within that space. The pain associated with compartment syndrome often exceeds what would be expected from the injury or trauma sustained, leading to the description of it as "out of proportion."

Patients often describe the pain as severe, worsening with passive stretching of the affected muscles. This symptom can be critical for early diagnosis, as timely intervention is necessary to prevent irreversible damage to the tissues.

While pallor, decreased mobility, and increased warmth may also be observed in patients with compartment syndrome, they are not as definitive or sensitive as pain out of proportion. Pallor can suggest circulatory disturbances, but it may take longer to appear and is not specific to compartment syndrome alone. Decreased mobility may be an effect of the pain or swelling in the compartment but does not signify the presence of increased intracompartmental pressure. Increased warmth can occur with inflammation or infection and is not a primary indicator of compartment syndrome. Thus, the disproportionate pain is the most critical and specific sign to look for when suspecting compartment syndrome.