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IMAGE QUIZ ARCHIVE

Image Quiz
Bilateral Anterior Tibial Pain in a Football Player1
A twenty-one-year-old male college football player related a five-year history of recurrent pain in both shins. The pain had worsened during the early part of the football season, when practices were held twice a day. Typically, the pain was most severe when the patient began running but would subside within a few minutes and then return on resumption of weight-bearing activity.
Clinical examination revealed moderate tenderness extending for a distance of 12 cm along the medial border of the distal and middle thirds of the right tibia, and mild tenderness in the corresponding area of the left tibia.
Radiographs had been made at regular intervals during the five years, and all had revealed normal findings.

What study(ies) would you order to arrive at a diagnosis?

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