Sclerosing Osteomyelitis of Garre of Tibia Diaphysis Masquerading as Recalcitrant Medial Tibial Stress Syndrome

Chronic sclerosing oteomyelitis of Garré is an uncommon form of bone infection with variable clinical presentations. Symptomatic cases have a swollen, tender segment of the affected bone that may require surgical decompression in refractory situation. The diaphyseal origin is a rare site and the diagnosis requires exclusion and histopathological correlation. The present case cites this lesion in tibial diaphysis, a rare site. The case was managed as medial tibial stress syndrome, a common overuse injury in atheletic children, before appropriate diagnosis and treatment. The report highlights importance of anticipating some underlying pathology in refractory cases and assistance of advance imaging technologies to help diagnose and treat them.