The management of acute sideline injuries often necessitates the triaging of medical conditions, differentiating between the symptoms that require immediate additional evaluation and those that can wait until after the athletic contest. In this light, we present a case report of a common athletic complaint, lower leg cramping, with a severe underlying etiology. This adolescent athlete was diagnosed subsequently with acute compartment syndrome in the bilateral lower extremities, requiring emergent care and surgical intervention. The lack of traumatic injury, absence of severe physical exertion, and seldom documented bilateral multicompartment distribution of pathology accent the rarity of this case. This case underscores the extreme importance of identifying subtle clinical differences in the presenting symptoms and physical examination findings of acute compartment syndrome that trigger immediate additional medical evaluation and potential intervention.
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