Presentation
Chronic lower leg pain.
Patient Data
Frontal and lateral views of both lower legs are normal.
Single phase bone scan performed using 20 mCi of Tc-99m MDP IV. #-hours after administration of radiotracer, lower body images were obtained in the anterior and posterior projections along with lateral views of the lower legs.
Images demonstrate abnormal increased radiotracer uptake in a linear distribution, involving the posteromedial cortices, both tibia.
Case Discussion
Medial tibial stress syndrome is also known as shin splints. It is a a spectrum of stress injuries that occurs typically in the mid-to-distal tibia, is often bilateral, and is prior to development of a stress fracture.
As in this case, radiographs are insensitive and typically normal.
Bone scintigraphy is more sensitive and will show increased radiotracer tibial shaft uptake in a linear distribution. This will appear medial on anterior and posterior views, and posterior on lateral views. Occasionally the abnormality will involve the anterior cortex, or present circumferentially.
Unable to process the form. Check for errors and try again.