Synonym
Medial tibial stress syndrome, periostitis, shin splints, ventral or dorsal tibial edge syndrome, functional compartment syndrome
Definition
Shinbone edge syndrome is a chronic pain syndrome in the area of one or more fascial compartments of the lower leg due to imbalances between muscle and fascia caused by sports. An indication of tibial edge syndrome is the patient’s statement that the pain begins after a running distance of about 500 m and is still present after the exercise. During the physical examination, a swollen skin or muscle in the middle and lower 2/3 of the tibia is noticeable.
The pain usually increases under pressure. Both of these symptoms are particularly severe after previous physical exercise. In severe cases of tibial edge syndrome, the skin in the area of the tibia may also be affected.
In most cases, the patient then expresses the corresponding complaints on request. A tuning fork can then be used to represent the sensations indicated. Imaging techniques are also used for diagnosis, but only to rule out other causes of the complaints, such as arthroses or stress fractures.
The imaging procedures used are conventional x-rays (exclusion of a fracture) or an MRI. While X-rays can mainly show bone involvement, magnetic resonance imaging (MRI) can also reveal oedematous swellings of the muscle. If necessary, a scintigraphy of the skeleton can also be performed.
This shows an increased storage, especially after a longer period of tibial edge syndrome, which can be interpreted as an inflammatory process in the muscle area. Neurological examinations, such as examination of the nerve conduction velocity (NLG) are only used in extreme and severe cases. The most reliable diagnosis of a tibial edge syndrome is the measurement of the pressure in the muscle compartment on the one hand before a load and on the other hand after a load.
The main symptoms of tibial edge syndrome are pain, initially during movement and later also at rest. The pain character of tibial edge syndrome is described as pulling to burning or stabbing. Sometimes it is located in the area of the point of origin, sometimes it is transmitted to the hip or foot.
Due to the excessive pressure in the affected compartments, the skin over the affected area may be tightly elastic. The skin tension can also cause pain. In some cases, patients also complain of sensitivity disorders in the area of the tightly stretched skin.
In advanced stages of the disease, pain is not only experienced during movement but also at rest. The excessive pressure on the muscles and the necroses that may develop can also lead to functional restrictions in certain muscle movements. Necrotizing muscle regions can also lead to a general systemic inflammatory reaction with high fever and fatigue, and possibly also to blood poisoning (sepsis).
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