Chronic leg pain: putting the diagnostic pieces together

Chronic pain in the calf, tibia, fibula, or muscle compartments of the leg must be carefully evaluated to make the proper diagnosis and define the most appropriate course of treatment. The most common overuse leg injuries are stress fractures, chronic exertional compartment syndrome, medial tibial stress syndrome, and strains and sprains. The history is the key component of the evaluation. Targeted questions can suggest which ancillary tests can confirm the working diagnosis. Infection, tumors, radiculopathy, and vascular compromise other than compartment syndrome are rare but must be considered in the differential.