The ultrasound images above were obtained from a 30-year-old, elite male distance runner with a history of proximal, lateral shin pain first noted one year prior to his initial visit, when he was averaging 90 miles (145 km) of running per week. The patient reduced their speed work and racing for one month and the pain gradually resolved, but a tender lump persists at the original site of pain.
(A) Normal-appearing muscle and bone with intact cortex distal to the site of pain.
(B and C) Bony callus and cortical irregularity (arrows) at the site of the fibular stress fracture.