Track athlete who reports persitent biulateral lower extremity pain.
Teaching points:
The mild to moderately increased activity at the mid shaft, posteromedial, periosteal aspects of the tibiae in an elongated distribution on the delayed images with symmetric perfusion and blood pool activity illustrates the classic findings of tibial stress syndrome otherwise know as “shin splints”.
This entity can be differentiated from a stress fracture, which generally demonstrates a discrete, fusiform distribution of more intensely increased activity on the delayed images. Also, stress fractures often demonstrate increased focal activity on the perfusion and blood pool images.
Distinction of these two entities is clinically useful in the young athlete as the required period of healing is significant longer with a stress fracture.
