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Shin Palpation Test

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Other Names

  • Shin Palpation Test
  • Focal Tenderness to Palpation
  • TTP Test
  • Tenderness to palpation test


Positioning for performing the focal tenderness to palpation test.[1]
  • Evaluate the tibia for a stress fracture


  • The patient is supine, hip and knee flexed with foot flat on the table
    • This allows for relaxation of the posterior compartment musculature, exposing the posteromedial tibia
  • Using index and middle fingers, palpate along the posteromedial shaft of the tibia
  • Positive test
    • Increased pain compared to baseline pain


  • As palpation is performed along the posteromedial tibial shaft, pen marks are made to delineate length
  • Positive if
    • Increased pain AND if the area of tenderness is ≤2.5 cm in length
  • Negative
    • Area of tenderness >2.5 cm.



  • Rosenthal et al[1]
    • Sensitivity: 48.6%
    • Specificity: 40.6%
    • PPV: 47.2%
    • NPV: 41.9%
    • PLR: 0.83
    • NLR: 1.27
    • Overall Accuracy: 45%

See Also


  1. 1.0 1.1 Rosenthal, Michael D., Mitchell J. Rauh, and James E. Cowan. "Prospective Assessment of Clinical Tests Used to Evaluate Tibial Stress Fracture." Orthopaedic Journal of Sports Medicine 10.9 (2022): 23259671221122356.
Created by:
John Kiel on 15 May 2023 06:53:33
Last edited:
15 May 2023 07:40:57