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Case Reports
. 2018 Mar 1:2018:bcr2017223186.
doi: 10.1136/bcr-2017-223186.

Chronic osteomyelitis of the tibia in a runner: catastrophic consequences of shin splints

Yunes Nadim Hammad  1 , Abigail Johnson  1 , Alan Norrish  1
Affiliations
Case Reports

Chronic osteomyelitis of the tibia in a runner: catastrophic consequences of shin splints

Yunes Nadim Hammad et al. BMJ Case Rep. .

Abstract

Medial tibial stress syndrome and chronic osteomyelitis are conditions that are traditionally thought to affect very different patient groups. We present a case of shin splints in a recreational long-distance runner, complicated by chronic osteomyelitis of the tibia. This is a unique case in which the microtrauma resulting from shin splints was implicated as an entry point for bacterial infection into the bone. Clinical evaluation and bone biopsy culture results indicated haematogenous spread of bacteria originating from the oral cavity. The patient required surgical resection of the affected bone and a prolonged course of intravenous antibiotic treatment. We illustrate that when shin splints show signs of acute inflammation with delayed recovery, the possibility of osteomyelitis should be kept in mind.

Keywords: bone and joint infections; musculoskeletal and joint disorders; orthopaedic and trauma surgery; orthopaedics; sports and exercise medicine.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
X-ray of the patient’s right tibia showing a well-defined linear lucency in the mid-tibia with a marked anterior tibial periosteal reaction.
See this image and copyright information in PMC

References

    1. Beck BR. Tibial stress injuries. An aetiological review for the purposes of guiding management. Sports Med 1998;26:265–79. - PubMed
    1. Lopes AD, Hespanhol LC, Yeung SS, et al. What are the main running-related musculoskeletal injuries? Sports Medicine 2012;42:891–905. 10.1007/BF03262301 - DOI - PMC - PubMed
    1. Yates B, White S. The incidence and risk factors in the development of medial tibial stress syndrome among naval recruits. Am J Sports Med 2004;32:772–80. 10.1177/0095399703258776 - DOI - PubMed
    1. Moen MH, Holtslag L, Bakker E, et al. The treatment of medial tibial stress syndrome in athletes; a randomized clinical trial. Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2012;4 10.1186/1758-2555-4-12 - DOI - PMC - PubMed
    1. Johnston E, Flynn T, Bean M, et al. A randomized controlled trial of a leg orthosis versus traditional treatment for soldiers with shin splints: a pilot study. Mil Med 2006;171:40–4. 10.7205/MILMED.171.1.40 - DOI - PubMed

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