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Fredericson MRI classification of medial tibial stress syndrome

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Craig Payne, Jan 20, 2013.

  1. Craig Payne

    Craig Payne Moderator


    Members do not see these Ads. Sign Up.
    I kind of missed this....

    Diagram of classification here

    Tibial stress reaction in runners. Correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system.
    Fredericson M, Bergman AG, Hoffman KL et-al.
    Am J Sports Med. 23 (4): 472-81. 1995
    Validation of MRI classification system for tibial stress injuries.
    Kijowski R, Choi J, Shinki K et-al.
    AJR Am J Roentgenol. 2012;198 (4): 878-84.
  2. Admin2

    Admin2 Administrator Staff Member

  3. I have been mentioning Fredrericson's classifications system on medial tibial stress syndrome/fracture in my lectures on medial tibial stress injuries for quite a few years now.

    Here is the lecture I gave over seven years ago in Melbourne on MTSS where I mentioned Fredericson's excellent paper that, I believe, everyone treating athletes should read.

  4. talarius

    talarius Welcome New Poster

    My first post so hope I don't appear to be the 'dork' of the Arena. And I don't know how to change my user name either but my name is Sally so hope this covers the anon problem too.
    I get the feeling I am going to be shouted at for not knowing the answer to my question so apologies in advance. But is there any further correlation between this and Type 1 insulin-dependant childhood onset diabetes?
  5. Ella Hurrell

    Ella Hurrell Active Member

    Hi Sally

    Welcome to Pod Arena :)

    Don't mean to be rude, but did you mean to post your question on this thread? Can't say I've ever noticed a correlation between MTSS and diabetes.
  6. talarius

    talarius Welcome New Poster

    Well I think that should be my first and last! Know you don't mean to be rude but think this may be a reason why members are reluctant to participate and give their full names! Yes I did mean to post on this thread as was thinking along lines of diabetic muscle infarction and also delayed tendon repair and just wondered if there were any further studies in that vein. Have a patient to has been sent from pillar to post among the 'experts' to no avail so looking 'outside the box'.
  7. Sally:

    Medial tibial stress syndrome and medial tibial stress fracture are seen nearly always in running and jumping athletes and has no correlation, to my knowledge, to Type 1 diabetes.
  8. blinda

    blinda MVP

    Hi Sally,

    :welcome: to the Arena.

    Being an `anon` really is not a problem, from my perspective, so long as posters don`t try to hide behind anonymity in order to deliberately provoke animosity and belittle those who come here with the desire to learn. So, don`t apologise for wanting to discuss a pertinent point which you have raised.

    I can understand why Ella (who, incidently is the most inoffensive person I have ever had the pleasure to meet) asked if you meant to post your question in this thread as, at first glance, there may not appear to be a connection of MTSS with diabetes....but actually you do have a point.

    It may not be a correlation, but there will be some people out there who have DM1 (or DM2) but are not yet diagnosed, or are recently diagnosed and still struggling to maintain blood sugar control. Sometimes these will present as pts with a slow healing injury, such as MTSS, or any other sports injury.

    So, stick around and please don`t stop posting here. Asking questions is one of the best ways to learn :drinks

  9. Ella Hurrell

    Ella Hurrell Active Member

    Thanks Bel ;)

    Sally - I certainly did not mean to offend, or in any way stifle your contribution / belittle question. I merely suspected that you may have accidentally posted on the wrong thread as you did not elaborate on the connection between the two conditions. With your second post, I now understand the angle you were coming from. I apologise if I have caused offence and certainly hope it will not put you off future postings. :drinks
  10. talarius

    talarius Welcome New Poster

    Hello Bel and Ella
    Thank you both for those comments - feel do now feel better about having posted a question.
    I undertand the causes/effects of DM in particular with reference to the feet and the principles of MTSS as detailed by Kevin et al. What I was trying to get to is whether there is any research specifically to the two insofar as there are links between MTSS, decreased bone marrow, bone density ( which can occur with DM) increased tendon injury and so on. I do realise this is 'off the wall' and if there are no links or no research then I''m happy to shut up about it!
    It is, as I say, because I have a patient who is not responding to well to treatment so far despite excellent help, support and advice from the Physios, orthopods and other specialists, inc me, involved his care.
  11. Sally:

    Have you considered that your patient may not have medial tibial stress syndrome and may, in fact, have some other condition?

    If you could give us more patient history, lab/xray/mri results and physical examination findings, then we could help you sort out what exactly the diagnosis of your patient is.

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