It was found that MTSFs occur with lengths of tibial tenderness up to ten cm. The usual threshold of 5 cm of tibial tenderness, which is commonly used to differentiate MTSS and MTSF, is not supported by the findings in this study or by existing literature.
The hop test had a sensitivity of 100 percent, specificity of 45 percent, a positive predictive value of 74 percent, and a negative predictive value of 100 percent considering the presence of pain and tenderness, with an odds ratio of 57.52. Conversely, the fulcrum test did not appear to have an association with the presence of stress fracture. Self-reported pain scores were not predictive of medial tibial stress fracture.
In case of requiring a bone scan, the rest periods were as follows: grade I – 1 week; grade II – 2 weeks; grade III – 4 weeks; grade IV – 6 weeks. When managed according to protocol, symptoms resolved in two thirds of the cases.