The Journal of Musculoskeletal Medicine Vol 25 No 3

Evaluating shin pain in active patients

February 28, 2008

Shin pain is a common complaint in runners and otheractive patients. Making a diagnosis can be difficult because the differentialis broad and symptoms may overlap. Palpation is an importantpart of the physical examination. The primary presentingsymptom in medial tibial stress syndrome, or "shin splints," is painlocalized to the medial border of the distal third of the tibia. Relativerest eliminates the inciting activity. The most obvious examinationfinding in tibial stress fractures is localized bony tenderness; triplephasebone scanning is the gold standard in making a diagnosis.High-risk fractures require aggressive management. The mainstay ofdiagnosis of chronic exertional compartment syndrome is measurementof resting and postexercise compartment pressures. Treatmentmay be conservative or surgical. (J Musculoskel Med. 2008;25:138-148)