A 15-year-old obese girl presented to clinic with increasing right shin pain of 4 weeks’ duration. The pain began after the patient began to play competitive basketball and was localized to her mid shin. Dietary and menstrual histories revealed no abnormalities. Examination demonstrated focal tenderness along the distal mid shaft of the tibia anteriorly. The single-leg hop test elicited severe localized pain. Radiographs were obtained for further evaluation (Figure).
Davis BJ, Estes AR. An Adolescent With Right Shin Pain. JAMA. 2015;313(15):1566-1567. doi:10.1001/jama.2014.17016