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

Abstract

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).

Application of nuclear medicine techniques in sports medicine

“…Fluorine-18 (18F) is one of the main emitters of these particles in nuclear medicine. [11] Glucose labeled with 18F (18F-FDG) forms a complex that is taken up by cells with increased glucose metabolism. [12] After entering the cytoplasm through glucose transporters, this complex is metabolized into FDG-6-phosphate.…”

“…They found that SPECT/CT imaging demonstrated high diagnostic accuracy for detecting prosthesis loosening in these cases. [11]…”

“…Expanding the examination to include SPECT/CT uncovered a stress fracture in the proximal part of the tibia. [11] Moreover, recent studies suggest the superiority of NaF-PET/CT over conventional methods in detecting pathological fractures, stress fractures, and occult fractures. [19]…”