An army recruit, smoker and 6 months into training staed complaining of pain at postero medial aspect of both legs. There was acute point tenderness and the pain was aggravated on physical activity. The most likely diagnosis is:
The army man is most likely suffering from stress fracture. Stress Fracture or fatigue fracture is caused by repeated stress at one point. Bones are constantly trying to repair and remodel themselves in people like athletes and army recruit. Over a period if sufficient stress is applied on a bone which has reached the limit of remodeling, a fracture may occur. Most common fracture sites are tibia (soldiers, runners), metatarsals (dancers) and calcaneus. Ref: Monitoring Metabolic Status: Predicting Decrements in Physiological and Cognitive Performance By Institute of Medicine (U.S.) 2004 ; Textbook of Ohopedics By John Ebneza, 4th Edition, Page 695 ; Radiology Review Manual By Wolfgang Dahner, 7th Edition, Pages 85-6
Gout
Stress fracture
Insufficiency stress fracture
Lumbar canal stenosis