A 22-year-old army recruit has anteromedial leg pain that appears with running and settles within minutes of stopping. There is diffuse tenderness along the middle third of the tibia, and radiographs are normal. What is the most likely diagnosis?

• A Chronic exertional compartment syndrome
• B Superficial peroneal nerve entrapment
• C Tibial stress fracture
• D Medial tibial stress syndrome ✓

Explanation

Medial tibial stress syndrome (shin splints) gives diffuse pain along the distal two thirds of the posteromedial tibial border, worse at the start of activity, easing as exercise continues, with normal early radiographs. A tibial stress fracture produces focal point tenderness and pain that worsens progressively through activity, which distinguishes it from the key case. Compartment syndrome presents with tightness, paraesthesia and pain increasing during exercise rather than settling.

Reference: DeLee and Drez's Orthopaedic Sports Medicine, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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