Background: Medial tibial stress syndrome (MTSS) or shin splints is the result of soft tissue injuries surrounding the tibial shaft. The most common causative factor is that of repetitive trauma while doing exertional exercises and maneuvers. These injuries cause pain in the lower leg and affect the lower part of the tibia shaft. This is frequently encountered in athletes and dancers. Case presentation: We present a 22 year old college student who happened to be in the athletic team and reported with the left leg pain. Various radiological investigations diagnosed him as a case of medial tibial stress syndrome (MTSS). Magnetic resonance imaging played a pivot role in grading the injury and patient was advised accordingly. Conclusion: MTSS may remain unnoticed until the time it causes concern of non-resolving pain of the lower leg. The case requires careful evaluation for the management purpose. Fredericson MRI classification helps in deciding about the conservative or surgical management.

Keywords: MTSS, shin splints, soft tissue, repetitive trauma, magnetic resonance imaging, case report.