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Chronic osteomyelitis of the tibia in a runner: catastrophic consequences of shin splints
  1. Yunes Nadim Hammad,
  2. Abigail Johnson,
  3. Alan Norrish
  1. Trauma and Orthopaedic Surgery, Addenbrooke’s Hospital, Cambridge, UK
  1. Correspondence to Dr Yunes Nadim Hammad, hammad.nadim{at}


Medial tibial stress syndrome and chronic osteomyelitis are conditions that are traditionally thought to affect very different patient groups. We present a case of shin splints in a recreational long-distance runner, complicated by chronic osteomyelitis of the tibia. This is a unique case in which the microtrauma resulting from shin splints was implicated as an entry point for bacterial infection into the bone. Clinical evaluation and bone biopsy culture results indicated haematogenous spread of bacteria originating from the oral cavity. The patient required surgical resection of the affected bone and a prolonged course of intravenous antibiotic treatment. We illustrate that when shin splints show signs of acute inflammation with delayed recovery, the possibility of osteomyelitis should be kept in mind.

  • sports and exercise medicine
  • musculoskeletal and joint disorders
  • bone and joint infections
  • orthopaedics
  • orthopaedic and trauma surgery

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  • Contributors YNH, AJ and AN have contributed to planning, writing and editing the case report.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.