Presentation
Pain in the anteromedial aspect of both legs
Patient Data
Fluid-sensitive sequences (SITR) show significant edema 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 edema (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 edema visible on MRI as fluid in the anteromedial sector to the cortex of the tibial shaft.
Subjacent bone marrow edema then begins to develop, followed by bone remodeling and diffuse osteopenia, with the risk of progressing to a stress fracture.