Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chronic, dull, aching pain localized to the tibial diaphysis. Pain is characteristically worse at night and exhibits a dramatic, rapid response to NSAID administration. No history of trauma, fever, or constitutional symptoms.
Clinical Examination Findings
Physical examination reveals localized tenderness over the tibial diaphysis. No palpable mass, erythema, or warmth noted. Range of motion of the knee and ankle joints is full and painless. Neurovascular status of the distal extremity is intact with palpable dorsalis pedis and posterior tibial pulses.
Treatment Protocol
Initial management includes a trial of scheduled NSAIDs (e.g., Ibuprofen or Naproxen) to manage symptoms. If refractory to conservative therapy or if long-term medication is undesirable, consider image-guided radiofrequency ablation (RFA) or surgical excision of the nidus.