Presentation
Pain in the anteromedial aspect of both legs
Patient Data
Fluid-sensitive sequences (SITR) show significant oedema in relation to the anteromedial margin of the tibial cortex in the middle third of the tibial diaphysis bilaterally and symmetrically.
There is no evidence of underlying bone marrow oedema (Fredericson grade 1).
Case Discussion
Stress injuries represent a spectrum of bone abnormalities in healthy bones, in response to chronic stress. The vast majority affect the tibia and more specifically the middle third of the tibial diaphysis. This is known as medial tibial stress syndrome (shin splints).
According to the Fredericson MRI classification, one of the early signs of this pathology is periosteal oedema visible on MRI as fluid in the anteromedial sector to the cortex of the tibial shaft.
Subjacent bone marrow oedema then begins to develop, followed by bone remodelling and diffuse osteopenia, with the risk of progressing to a stress fracture.
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