Abnormally decreased regional bone density in athletes with medial tibial stress syndrome

Medial tibial stress syndrome, a common condition of uncertain origin found in athletes, is characterized by pain in the distal posteromedial aspect o f the tibia during exercise, with or without increased scintigraphic uptake in the affected region. To determine whether medial tibial stress syndrome with increased scintigraphic uptake is associated with a change in tibial bone mineral density confined to the site of the increased uptake, we measu red bone mineral density (in grams per square centimeter) in 18 adult male athletes with long-standing medial tibial stress syndrome and compared the measurements with those of 16 age-and sex-matched control subjects and with those of 18 athletes without medial tibial stress syndrome who had a compa rable training regimen. Tibial bone mineral density in the region correspon ding to the pain was 15% +/- 9% lower in the patients than in control subje cts and 23% +/- 8% lower than in the athletic control subjects (both signif icant differences). Bone mineral densities in most other regions of the bod y were higher than in the control subjects but lower than in the athletic c ontrols at the corresponding sites. In summary, medial tibial stress syndro me is associated with low regional bone mineral density.