"Shin Splints"

General Considerations

• Catch-all term used to describe almost any pain in tibia
• The most common cause of shin splints is medial tibial stress syndrome
• Seen in military personnel and amongst athletes
• Exercise induced pain and tenderness along posterior-medial border of tibia
• Usually seen in athletes who increase their training

Clinical Findings

• Dull, aching pain on posterior and medial aspect of calf
• Frequently occurs at beginning of a sports season

Imaging Findings

• Conventional radiographs are normal
• Nuclear medicine bone scans
• Blood pool images are normal
• Long, longitudinally-oriented uptake on delayed images in posterior tibia
• Tracer uptake varied along length of lesion
• Must obtain both lateral and medial views
• Findings differentiate shin splints from stress fractures

Differential Diagnosis

• Stress fracture
• Chronic compartment syndrome
• DVT
• Muscle strain

Treatment

• Rest
• Ice
• Compression
• Elevation

"Shin Splints." White arrows point to linear region of increased uptake in tibia on delayed radionuclide"Triple phase" bone scan images consistent with so-called shin splints in this young athlete. The blood flow study shows equal flow in both calves (red circle) .
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The Specific Scintigraphic Pattern of  Shin Splints in the Lower Leg: Concise Communication.  Lawrence E. Holderand and Roger H. Michael. J Nuci Med 25: 865-869, 1984