Musculo-skeletal   [back to the Category]

Tibial periostitis   [read the french version]

Author :   Docteur Anne Thiescé

Tibial periostitis is a painful inflammatory syndrome of the middle two thirds of the tibia, linked to myo-tendino-periosteal lesions caused by over-exercising.

It can be the result of excessive pulling on the periosteum by the insertions of the aponevroses and/or a straight periosteum pain. The areas usually involved are the tibia insertion zones of the posterior and anterior tibial muscles.

Pain is spontaneous, increased by palpation and exertion especially jumps. It remains stable until such time as it is treated.

The disorder is caused by a technical fault such as poor quality flooring, foot support flaws (pronator foot) and the use of shoes too heavy for walking.

X-rays eliminate any other osseous disorder and occasionally show a slight periosteal reaction.

The scintigraphy can be normal or show a moderate longitudinal hyperfixation. The M.R.I. is normal or shows juxtacortical and extraosseous anomalies.

Treatment necessitates:
ten days of complete rest if the pains are recent, an ice application twice daily, physiotherapy, local anti-inflammatory treatments and short bone treatments, a re-education with progressive stretching of the leg muscles.

Bibliography :

Commandré F.A., Zakarian H., Argenson C.: 3 foulées, 3 risques : Périostite tibiale-Fracture de fatigue-Syndrome de loges

Demarais Y., Lucas D., Parier J., Poux D.: Diagnostic d’une douleur de jambe et éléments de traitement chez le sportif.: Médecins du sport,1997, 10, 11-22.

De Labareyre H., Demarais Y.: Douleurs tibiales: périostites ou fracture de fatigue. Abstract Rhumato., 2000, 207,20-22.