The evaluation of medial tibial stress syndrome starts with a history and physical examination.

Physical findings in someone with medial tibial stress syndrome may include:

• Limping due to leg pain
• Mild tenderness over the posterior tibialis muscle
• No tenderness over the tibia or other bones

Testing is not necessary to make the diagnosis of medial tibial stress syndrome. Tests may be used to exclude a tibial stress fracture.

Tests that may be used to evaluate medial tibial stress syndrome include:

• X-rays of the tibia
• Nuclear medicine bone scan