A member asked:

Hi runner has hard boney lump on shin.x-ray results; focal cortical thickening along anterior tibial shaft. focal beaking anterior tibial cortex mid shaft. evid. of unicortical stress fract is this an old s/f or new one? no or little pain present?

2 doctors weighed in across 2 answers
Dr. Hiep Le answered

Specializes in Nephrology and Dialysis

By UPTODATE: Symptoms and signs precede the appearance of radiographic findings by weeks, and confirmation of the injury on the initial plain radiographs occurs in fewer than half of tibial stress fractures. It means the X-ray may be negative if it's done several weeks earlier when you just had the pain. The described findings are consistent with runner's stress fracture.

Answered 9/8/2021

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Bony thickening and beaking are signs of new bone formation, which is representative of fracture healing. Anterior tibial stress fractures are, however, considered high risk stress fractures. Therefore, while there is evidence of bony healing, I would still recommend this runner is followed very closely with slow return to training to be sure that this continues to heal.

Answered 9/18/2021

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