Diagnosis of Stress Fractures in Pediatric Patients
The athlete with shin pain presents a difficult diagnostic problem. As many as 20% of these patients may have stress fractures, and the only effective treatment is prolonged (6 to 10 weeks) rest from sports. Continuation of activity can lead to a complicated and protracted course. It is important, therefore, to separate fracture from other common causes of shin pain, ie, "shin splints" (when severe called the anterior tibial compartment syndrome) and tendonitis. The diagnosis can often be made clinically by the finding of localization of tenderness (over the anterior tibial tendon in tendonitis and over the lower two thirds of the medial-tibial area in shin splints). With a stress fracture, the tenderness is usually localized.
