We had an image sent to us a few days ago with a brief explanation surrounding the situation. The patient is a healthy middle aged female competitive triathlete with ~12 months ongoing shin pain. The imaging referral stated as such; ’12 months of ongoing shin pain related to activity.’ Strangely the imaging report returned a…
Director of Bartold Clinical
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Tibia looks to have 4 stress #’s on medial mid portion, a lot of periosteal thickening suggestive of long standing bone stress related to running training I suppose.
Great observations Peter. It’s close but no cigar!
Let’s keep the conversation rolling. Diagnosis is only a part of the whole picture. Lets follow through with the rest of the story, aetiology, management etc etc
Diagnosis: Anterior Tibial Stress Fracture
Aetiology: Insufficient rest between repetitive loading -bone “bowing” anteriorly
Treatment: Cease from aggravating activity immediately. Non-weight bearing cast for 6-8 weeks, a form of surgery to promote cortical union?, bone growth electrical stimulation?
Prognosis: Clinical and radiographical monitoring utilized to progress into weight bearing and eventually returning to full activity at about 3-4 months?
on the money! what is the general prognosis? ie; response to management longer term…?
Prognosis is likely to be not very good! …likely to never return to the intensity of the impeding exercise!?