“Shin Splint” Syndrome and Tibial Stress Fracture in the Same Patient Diagnosed by Means of 99mTc-HMDP SPECT/CT

Vicente, J. Serrano; Grande, M.L. Domínguez; Torre, J.R. Infante de la; Madrid, J.I. Rayo; Barquero, Carmen Durán; Bernardo, Lucía García; Sánchez, R.

doi:10.1097/rlu.0b013e318263953b

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…Coexistence and interrelationships of these entities is acknowledged but not clearly understood 1. Inconsistent use of terminology, such as “shin splint syndrome” and “soleus enthesopathy”, is evident in the historic and current literature, and it is likely that such variation in nomenclature has contributed to the current lack of understanding of the condition 2,3…”

Section: Introductionmentioning

confidence: 99%

“…Only a limited number of histologic studies have included bone biopsy, but these positively confirm bone stress markers 6,7. Some imaging studies demonstrate bony lesions associated with a clinical diagnosis of MTSS in sites such as the proximal tibia and the anterolateral tibial cortex, that are inconsistent with clinically significant sites of pain,3,19 and this raises questions about the differential diagnosis of MTSS as well as about the nature of the pathology itself.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis

Newman¹,

Witchalls²,

Waddington³

et al. 2013

OAJSM

125

114

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BackgroundMedial tibial stress syndrome (MTSS) affects 5%–35% of runners. Research over the last 40 years investigating a range of interventions has not established any clearly effective management for MTSS that is better than prolonged rest. At the present time, understanding of the risk factors and potential causative factors for MTSS is inconclusive. The purpose of this review is to evaluate studies that have investigated various risk factors and their association with the development of MTSS in runners.MethodsMedical research databases were searched for relevant literature, using the terms “MTSS AND prevention OR risk OR prediction OR incidence”.ResultsA systematic review of the literature identified ten papers suitable for inclusion in a meta-analysis. Measures with sufficient data for meta-analysis included dichotomous and continuous variables of body mass index (BMI), ankle dorsiflexion range of motion, navicular drop, orthotic use, foot type, previous history of MTSS, female gender, hip range of motion, and years of running experience. The following factors were found to have a statistically significant association with MTSS: increased hip external rotation in males (standard mean difference [SMD] 0.67, 95% confidence interval [CI] 0.29–1.04, P<0.001); prior use of orthotics (risk ratio [RR] 2.31, 95% CI 1.56–3.43, P<0.001); fewer years of running experience (SMD −0.74, 95% CI −1.26 to −0.23, P=0.005); female gender (RR 1.71, 95% CI 1.15–2.54, P=0.008); previous history of MTSS (RR 3.74, 95% CI 1.17–11.91, P=0.03); increased body mass index (SMD 0.24, 95% CI 0.08–0.41, P=0.003); navicular drop (SMD 0.26, 95% CI 0.02–0.50, P=0.03); and navicular drop >10 mm (RR 1.99, 95% CI 1.00–3.96, P=0.05).ConclusionFemale gender, previous history of MTSS, fewer years of running experience, orthotic use, increased body mass index, increased navicular drop, and increased external rotation hip range of motion in males are all significantly associated with an increased risk of developing MTSS. Future studies should analyze males and females separately because risk factors vary by gender. A continuum model of the development of MTSS that links the identified risk factors and known processes is proposed. These data can inform both screening and countermeasures for the prevention of MTSS in runners.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis

Newman¹,

Witchalls²,

Waddington³

et al. 2013

OAJSM

125

114

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“…In contrast, BS has the ability to depict areas of even subtle osseous turnover and bone remodeling within hours of injury providing sensitivities between 74% and 100% for the detection of stress injuries. [ 4 6 ] Although the management of these two entities is different, and are clinically difficult to distinguish. The stress fracture responds only to rest, whereas “shin splint'' pain responds to anti-inflammatory drugs and the patient can continue with physical activity.…”

Section: Discussionmentioning

confidence: 99%

Tibial stress fracture and “Shin Splint” syndrome in the same patient diagnosed on ^99mTC-Methylene diphosphonate bone scintigraphy and single-photon emission/computed tomography

et al. 2023

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We present a case of an 18-year-old male athlete who presented with complaints of right lower leg pain for 10 days following intense exercise. The most likely diagnosis was a possible tibial stress fracture or a ''shin splint'' syndrome. The radiograph did not reveal any significant abnormality in the form of any fracture or a cortical break. We performed planar bone scintigraphy including single-photon emission computed tomography (CT)/CT that revealed the presence of the two concomitant pathologies in the form of a hot spot which corresponded with a bone lesion in the tibial stress fracture and subtle remodeling activity without evidence of significant cortical lesion in the shin splints in bilateral lower limbs (R>L).

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“…85 In another case, SPECT/CT was able to accurately diagnose concomitance of both a tibial stress fracture and tibial stress syndrome. 89 Figure 2 demonstrates the use of SPECT/CT in the diagnosis of a calcaneal stress fracture.…”

Section: Clinical Uses In Orthopedic Foot and Ankle Surgerymentioning

confidence: 99%

Nuclear Medicine for the Orthopedic Foot and Ankle Surgeon

et al. 2020

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Nuclear medicine has been widely applied as a diagnostic tool for orthopedic foot and ankle pathology. Although its indications have diminished with improvements in and the availability of magnetic resonance imaging, nuclear medicine still has a significant and valuable role. The present article offers a comprehensive and current review of the most common nuclear imaging modalities for the orthopedic foot and ankle surgeon. Methods discussed include bone scintigraphy, gallium citrate scintigraphy, labeled-leukocyte scintigraphy, and single-photon emission computed tomography (SPECT). We review the indications and utility of these techniques as they pertain to specific foot and ankle conditions, including osteomyelitis, stress fractures, talar osteochondral lesions, complex regional pain syndrome, oncology, plantar fasciitis, and the painful total ankle arthroplasty. We conclude with a discussion of our approach to nuclear medicine with illustrative cases. Level of Evidence: Level V, expert opinion.

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“Shin Splint” Syndrome and Tibial Stress Fracture in the Same Patient Diagnosed by Means of 99mTc-HMDP SPECT/CT

Cited by 6 publications

References 10 publications

Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis

Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis

Tibial stress fracture and “Shin Splint” syndrome in the same patient diagnosed on ^99mTC-Methylene diphosphonate bone scintigraphy and single-photon emission/computed tomography

Nuclear Medicine for the Orthopedic Foot and Ankle Surgeon

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“Shin Splint” Syndrome and Tibial Stress Fracture in the Same Patient Diagnosed by Means of 99mTc-HMDP SPECT/CT

Cited by 6 publications

References 10 publications

Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis

Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis

Tibial stress fracture and “Shin Splint” syndrome in the same patient diagnosed on 99mTC-Methylene diphosphonate bone scintigraphy and single-photon emission/computed tomography

Nuclear Medicine for the Orthopedic Foot and Ankle Surgeon

Contact Info

Product

Resources

About

Tibial stress fracture and “Shin Splint” syndrome in the same patient diagnosed on ^99mTC-Methylene diphosphonate bone scintigraphy and single-photon emission/computed tomography