Assessment of Calf Skeletal Muscle Stiffness in Diabetic Nephropathy Patients with Medial Tibial Stress Syndrome by Two-Dimensional Shear Wave Elastography

Objective:To explore the feasibility of two-dimensional shear wave elastography in evaluating calf skeletal muscle stiffness in diabetic nephropathy patients with medial tibial stress syndrome.Methods:A total of 48 diabetic nephropathy patients with medial tibial stress syndrome from January 2020 to December 2022 were included as the study group,and 48 patients with diabetic nephropathy during the same period were included as the control group.Both groups were detected by two-dimensional shear wave elastography with ultrasonic equipment,and Young‘s modulus of the tibialis anterior muscle,tibialis posterior muscle,and gastrocnemius muscle were observed and analyzed in the two groups.Results:The Young‘s modulus values of tibialis anterior muscle,tibialis posterior muscle,and gastrocnemius muscle in the study group were significantly lower than those in the control group(P<0.05).Conclusion:Two-dimensional shear wave elastography is feasible for the evaluation of calf skeletal muscle stiffness in diabetic nephropathy patients with medial tibial stress syndrome,and has high accuracy and repeatability.This technique can be used to diagnose,treat and monitor muscle lesions in patients with diabetic nephropathy,and can also be used to assess muscle fatigue and exercise capacity,which has broad application prospects.

Femoral neck stress fracture and medial tibial stress syndrome following high intensity interval training: A case report and review of literature

BACKGROUND Femoral and tibial stress injuries are commonly found in long distance running athletes.Stress fractures have rarely been reported in athletes performing high intensity interval training(HIIT)exercise.The objective of this study was to report a case of a patient who presented with medial tibial stress syndrome and femoral neck stress fracture after performing HIIT exercises.CASE SUMMARY A 26 year old female presented with bilateral medial tibial pain.She had been performing HIIT exercise for 45 min,five times weekly,for a seven month period.Her tibial pain was gradual in onset,and was now severe and worse on exercise,despite six weeks of rest.Magnetic resonance imaging(MRI)revealed bilateral medial tibial stress syndrome.As she was taking norethisterone for birth control,a dual energy X-ray absorbitometry scan was performed which demonstrated normal bone mineral density of her lumbar spine and femoral neck.She was managed conservatively with analgesia and physiotherapy,but continued to exercise against medical advice.She presented again six months later with severe right hip pain.MRI of her right hip demonstrated an incomplete stress fracture of her subtrochanteric region.Her symptoms resolved with strict rest and physiotherapy.CONCLUSION HIIT may cause stress injury of the tibia and femur in young individuals.

Medial Tibial Stress Syndrome and Female Military Recruits

Upon entering the military recruits are challenged physically, this is exceptionally difficult for women as their anatomy predisposes them to more impact injuries than men. Female military recruits are placed at a higher risk for shin splints, a repetition injury known in the medical field as medial tibial stress syndrome (MTSS). This review paper explores studies about MTSS, its prevalence, and expression in military recruits, particularly as its expression differs across gender. This paper will cover how the external environment of boot camp results in a higher prevalence of MTSS than the general population and how increased occurrence of MTSS in females has been attributed to specific physical attributes. This includes smaller tibial cross-sectional dimensions, greater than average hip range of motion, and differences in lower extremity mechanics during running and other repetitive physical activities. The external environment of boot camp coupled with these intrinsic factors highlight the importance of providing running education for women prior to arrival at boot camp and designing training regiments that account for these physiological differences.