Bone Depressions: Causes and Concerns in the Shin

Bone depression?

Hello Doctor, I recently discovered (I'm not sure how long it's been) that there is a depression about 10 centimeters above my left ankle on the tibia, measuring approximately 3 centimeters in length.
This depression is not visible to the naked eye and can only be felt when I press it with my fingers (the right leg does not have a noticeable depression).
Additionally, on the lateral side of the same area of the tibia, I feel intense pain when I press on the muscle attachment point (the same area on the right leg also hurts, but to a lesser extent).
About three years ago, I experienced pain in my left calf as mentioned, and I sought medical attention (but at that time, it hurt even without pressure).
The doctor did not perform any tests and suggested it might be periostitis due to exercise.
I have indeed been jogging regularly and have ignored the pain when pressing down, but the recent discovery of the depression in my left calf has made me very concerned, especially since the condition does not seem to be the same on both sides.
I am wondering what the possible issues could be? Could it be something serious like bone cancer? I understand that diagnosing based on this information alone is not easy, so I hope you can ask me further questions via email.
I really appreciate it, as going to see a doctor can be a waste of time, and I’m unsure if I will receive satisfactory answers.
My email is [email protected].
I have previously consulted with other doctors online, and they briefly mentioned that I could get an X-ray or ultrasound to check for bone damage or soft tissue changes.
I would like to know what potential issues there could be and the likelihood of each, and whether the fact that I can feel the depression when pressing down indicates that the bone is damaged.
Please provide a detailed response.
Thank you very much, and I wish you good health.

Xiao An, 20~29 year old female. Ask Date: 2006/07/14

Dr. Shi Guozheng reply Orthopedics

Based on your description, it is necessary to consult a physician for an X-ray examination to determine any changes in the X-ray images, as relying solely on written descriptions cannot definitively identify any issues with the bones.
Bone cancer typically grows outward, meaning there will be a mass, and it is often painful, potentially leading to fractures.
The phenomenon of depression is less commonly observed in cases of bone cancer.

Reply Date: 2006/07/14

More Info

When it comes to understanding bone depressions, particularly in the shin area, there are several potential causes and concerns that need to be considered. The symptoms you describe—a depression in the tibia (shin bone) and localized pain—can be indicative of a few different conditions, and it’s important to approach this with a comprehensive understanding.

Firstly, the depression you feel in your left tibia could be a result of several factors, including but not limited to:
1. Bone Remodeling: If you have a history of physical activity, particularly high-impact activities like running, your bones may undergo remodeling. This is a natural process where bone tissue is broken down and rebuilt. However, if there is excessive stress or trauma, it can lead to localized changes in the bone structure, potentially causing a depression.

2. Stress Fractures: Repetitive stress on the bone can lead to microfractures, which may not be visible on standard X-rays initially. These stress fractures can cause localized pain and may lead to changes in the bone surface, including depressions.

3. Osteitis or Bone Inflammation: Conditions such as periostitis (inflammation of the periosteum, the tissue surrounding the bone) can cause pain and tenderness in the area. This inflammation can sometimes lead to changes in the bone surface.

4. Cysts or Benign Tumors: In some cases, benign bone lesions or cysts can develop, which may create a depression in the bone. These are generally not cancerous but can cause discomfort and changes in the bone structure.

5. Malignancy: While it is less common, the concern for bone cancer (primary or metastatic) should not be entirely dismissed, especially if there are other concerning symptoms such as significant pain, swelling, or systemic symptoms (like weight loss or fever). However, the likelihood of this being the cause is generally low, particularly if the pain is localized and related to activity.

Given your history of pain in the same area and the recent discovery of the depression, it is advisable to seek a thorough evaluation from a healthcare professional. While online consultations can provide some insight, a physical examination and imaging studies (like X-rays or an MRI) are crucial for an accurate diagnosis. These tests can help visualize the bone structure and any potential soft tissue involvement.

In terms of your immediate concerns, the fact that you can feel a depression and experience pain upon pressure does suggest that there may be some underlying issue with the bone or surrounding tissues. However, the presence of a depression does not automatically indicate that the bone is damaged; it could also be a result of other factors such as muscle attachment or inflammation.

In conclusion, while there are several potential explanations for the symptoms you are experiencing, it is essential to consult with a healthcare provider who can perform a physical examination and recommend appropriate imaging studies. This will help clarify the nature of the depression and guide you toward the best course of action for treatment and management. Remember, early intervention is key in addressing any potential issues, especially when it comes to bone health.

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