SHIN SPLINTS - MR APPEARANCE IN A PRELIMINARY-STUDY

PURPOSE: To investigate the magnetic resonance (MR) imaging appearance of activity-related lower leg pain (shin splints syndrome) and evalua te the relative involvement of bone and soft tissues. MATERIALS AND ME THODS: Nineteen patients with activity-related lower leg pain and tend erness on palpation along the posteromedial tibia (shin splints) under went clinical examination and MR imaging. Five also underwent plain ra diography. MR findings were compared with patient demographics, clinic al findings, and plain radiographs when available. RESULTS: Four MR pa tterns were identified: normal appearance (n = 7), periosteal fluid on ly (n = 5), abnormal marrow signal intensity (n = 5), and stress fract ure (n = 2). Increased symptom duration correlated strongly with a nor mal MR image (P =.002). Plain radiographs appeared normal in all five patients for whom they were available. CONCLUSION: Patients with acute shin splints have a spectrum of MR findings, which suggests this clin ical entity is part of a continuum of stress response in bone. The str ong association between chronic symptoms and a normal-appearing MR ima ge implies that this modality has less utility in these patients.