A prospective controlled study of diagnostic imaging for acute shin splints

Area of Science:

• Orthopedics
• Sports Medicine
• Diagnostic Imaging

Background:

• Acute shin splints, characterized by exercise-induced lower leg pain and tibial tenderness, are common in athletes.
• Accurate diagnosis is crucial for effective management and return to play.
• Conventional diagnostic tools include clinical examination, plain radiography (XR), triple-phase bone scan (TPBS), and magnetic resonance imaging (MRI).

Purpose of the Study:

• To investigate the relationship between clinical examination, XR, TPBS, and MRI in diagnosing acute shin splints.
• To compare the diagnostic accuracy of TPBS and MRI for exercise-induced lower leg pain.

Main Methods:

• Prospective observational study of 23 athletes with acute shin splints.
• Subjects underwent clinical examination, XR, TPBS, and MRI within two weeks.
• Four asymptomatic controls also underwent TPBS and MRI for comparison.

Main Results:

• TPBS identified abnormalities in 36/41 symptomatic legs; MRI showed abnormalities in 34/41.
• MRI demonstrated high sensitivity (95%) and moderate specificity (67%) compared to TPBS as the gold standard.
• Clinical examination showed lower sensitivity and specificity compared to imaging modalities.

Conclusions:

• MRI is a viable alternative to TPBS and XR for evaluating acute shin splints, especially when avoiding radiation is preferred.
• Both TPBS and MRI revealed abnormalities in asymptomatic limbs and controls, suggesting the need for further studies to define normal variations.
• Further research is recommended to establish definitive diagnostic criteria for TPBS and MRI in shin splints.