ISSN: 1899-0967
Polish Journal of Radiology
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vol. 83
Original paper

Tibial stress injuries – location, severity, and classification in magnetic resonance imaging examination

Agata Maria Gmachowska, Magdalena Żabicka, Ryszard Pacho, Szymon Pacho, Aleksandra Majek, Beata Feldman

© Pol J Radiol 2018; 83: e471-e481
Online publish date: 2018/11/05
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To describe and illustrate the spectrum of magnetic resonance imaging (MRI) findings of tibial stress injuries (TSI) and propose a simplified classification system.

Material and methods
Retrospective analysis of MRI exams of 44 patients with clinical suspicion of unilateral or bilateral TSI, using a modified classification system to evaluate the intensity and location of soft-tissue changes and bone changes.

Most of the patients were young athletic men diagnosed in late stage of TSI. Changes were predominantly found in the middle and distal parts of tibias along medial and posterior borders.

TSI may be suspected in young, healthy patients with exertional lower leg pain. MRI is the only diagnostic method to visualise early oedematic signs of TSI. Knowledge of typical locations of TSI can be helpful in proper diagnosis before its evolution to stress fracture.


stress, fractures, soft tissue injuries, athletic injuries, tibial stress syndrome, tibial fractures

Gaeta M, Minutoli F, Scribano E, et al. CT and MR imaging findings in athletes with early tibial stress injuries: Comparison with bone scintigraphy findings and emphasis on cortical abnormalities. Radiology 2005; 235: 553-561.
Taunton JE, Ryan MB, Clement DB, et al. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med 2002; 36: 95-101.
Fredericson M, Bergman AG, Hoffman KL, et al. Tibial stress reaction in runners: correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system. Am J Sports Med 1995; 23: 427-481.
Kijowski R, Choi J, Shinki K, et al. Validation of MRI classification system for tibial stress injuries. AJR Am J Roentgenol 2012; 198: 878-884.
Beck BR, Bergman AG, Arendt EA, et al. Tibial stress injury: relationship of radiographics, nuclear medicine bone scanning, MR Imaging, and CT severity grades to clinical severity and time to healing. Radiology 2012; 263: 811-818.
Franklyn M, Oakes B. Aetiology and mechanisms of injury in medial tibial stress syndrome: Current and future developments. World J Orthop 2015; 6: 577-589.
Hadid A, Moran DS, Evans RK, et al. Tibial stress changes in new combat recruits for special forces: patterns and timing at MR imaging. Radiology 2014; 273: 483-490.
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