Nielsen M B, Hansen K, Hølmer P, Dyrbye M
Høvelte Barracks, Birkerød, Denmark.
Acta Orthop Scand. 1991 Dec;62(6):531-4. doi: 10.3109/17453679108994489.
Twenty-two soldiers with tibial pain along the posteromedial tibial border (29 painful tibias) entered the study. The tibias were evaluated using radiographs and scintigraphs. Follow-up scintigraphs of 12 tibias were performed. The scintigraphic lesions were classified as Stages 0-V depending on the percentage of bone thickness involved. No attempts were made to differentiate between shin splints and stress fractures. Twenty-four symptomatic lesions and five asymptomatic lesions were found by scintigraphy. Radiographic changes were found in all the lesions classified as Stage III or higher, in some Stage II lesions, but never in Stages 0 and I lesions. Because intense scintigraphic uptake is seen in bone tumors, radiographs are needed to exclude this diagnosis. Radiographs were, however, not as sensitive as scintigraphs for differentiating the periosteal injuries seen in this study. The initial scintigraphs can be used to classify the lesions. Follow-up scintigraphs are not useful because they take months to return to normal. Consequently, the clinical symptoms and the level of pain should be the guidelines for treatment.
22名沿胫骨后内侧缘有疼痛的士兵（29条疼痛胫骨）进入研究。使用X线片和闪烁扫描对胫骨进行评估。对12条胫骨进行了随访闪烁扫描。根据受累骨厚度的百分比，将闪烁扫描病变分为0 - V期。未尝试区分胫骨应力综合征和应力性骨折。通过闪烁扫描发现了24个有症状的病变和5个无症状的病变。在所有分类为III期或更高期的病变、一些II期病变中发现了X线片改变，但在0期和I期病变中从未发现。由于骨肿瘤可见强烈的闪烁扫描摄取，因此需要X线片来排除该诊断。然而，X线片在区分本研究中所见的骨膜损伤方面不如闪烁扫描敏感。初始闪烁扫描可用于对病变进行分类。随访闪烁扫描无用，因为它们需要数月才能恢复正常。因此，临床症状和疼痛程度应作为治疗的指导原则。
