The three-phase bone scan is finding increasing utility in acute and chronic pain syndromes in sports medicine settings. This useful technique may have significant clinical application in assessing the increasing numbers of patients with exercise induced lower leg or medial tibial pain. The authors present a case of exertional lower leg pain or medial tibial pain in which three-phase bone imaging exhibited a dramatic increase in early flow after a simple derived exercise stress. The three-phase bone scan should play a key role in the assessment of exercise pain, and may be enhanced by the addition of simple exercise intervention.
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