Tibial stress syndrome in athletes.

Dr. Douglas B Clement, Richmond, British Columbia, is President of the Canadian Academy of Sports Medicine and a member of the Canadian Association of Sports Sciences and American College of Sports Medicine Current training methods in sport expose the athlete to higher and higher levels of stress and subsequent injury is all too common The athlete who presents with gradually increasing pain in the lower leg, followmg repetitive running or jumping offers a challenge in proper diagnosis and adequate treatment. Slocum’ has probed this challenging differential diagnosis and Devas2 has commented that one of the most disabling conditions presenting in this manner is a stress fracture of the tibia Traditionally this diagnosis is dependent on the radiological findings that Wilson and Katz3 describe as a combination of a fracture line, focal sclerosis of bone with endosteal callus or periosteal reaction with external callus. The de-