In the runner with leg pain, the differential diagnosis includes muscle and tendon injuries, chronic compartment syndrome, medial tibial stress syndrome, and stress fractures. Medial tibia syndrome is an early stage of a stress fracture. Periostitis with edema of the periosteum and endosteum may be caused by traction of the muscle or fascial attachments, or may be reactive to changes in the underlying bone.

Case courtesy: Dr. Fabio Denicolò

Radiographer: TSRM Fabio Imola

Radiographer: TSRM Nunzio Bianco