Pain in the shin ("shun splint") is a common problem for athletes who run. The cause can be infered from history and clinical examination but may require imaging studies for confirmation. Diagnostic problems can arise if more than one condition occurs simultaneously.
Conditions to distinguish:
(1) bone injury, ranging from mild damage to tibial stress fracture
(2) compartment syndrome
(3) tenoperiostitis (fascial inflammation)
Feature |
Bone Injury |
Compartment Syndrome |
Tenoperiostitis |
descriptor |
acute, sharp |
feeling of tightness, aching, claudication |
aching |
duration |
constant or increasing |
variable |
variable |
tibial location |
localized, usually lower third |
anterolateral |
medial tibial border |
better |
analgesics |
rest |
with exercise |
worse |
with impact, in the morning |
during exercise |
following exercise, in the morning |
tenderness |
bone |
none or minimal |
along muscle attachment |
other findings |
aching at night |
variable muscle weakness or sensory changes |
|
Diagnostic tests to consider:
(1) isotope bone scan
(2) MRI
(3) compartment pressure
Specialty: Surgery, orthopedic
ICD-10: ,