Differential Diagnosis for Severe Pain from Tightness in Anterior Tibialis, Achilles, and Extensor Hallucis after Running

• Single Most Likely Diagnosis
  • Shin Splints (Medial Tibial Stress Syndrome): This condition is characterized by pain and inflammation in the anterior tibialis muscle, often resulting from overuse or repetitive stress, such as running. The pain typically occurs in the front or sides of the lower leg.
• Other Likely Diagnoses
  • Achilles Tendinitis: Inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, can cause pain in the back of the ankle. Running can exacerbate this condition.
  • Extensor Hallucis Longus Tendinitis: This condition involves inflammation of the tendon that controls the big toe, leading to pain and stiffness, especially after activities like running.
  • Compartment Syndrome: Although more commonly associated with severe trauma, acute compartment syndrome can occur after intense exercise, leading to increased pressure within the muscle compartments, causing severe pain.
• Do Not Miss Diagnoses
  • Deep Vein Thrombosis (DVT): While less common, DVT can present with leg pain and swelling after physical activity. It's crucial to consider this diagnosis due to its potential for severe complications, such as pulmonary embolism.
  • Stress Fracture: A small crack in the bone, often caused by overuse, can lead to severe pain that worsens with activity. Stress fractures in the tibia or fibula could cause pain in the areas mentioned.
• Rare Diagnoses
  • Popliteal Artery Entrapment Syndrome: A rare condition where the popliteal artery is compressed, leading to leg pain during exercise.
  • Peripheral Artery Disease: Although more common in older adults, this condition involves narrowing of the arteries, which can cause leg pain during physical activity due to reduced blood flow.