Shin Tenderness As Diagnostic Tool for RA | Arthritis Information


This is amazing.  My shins are both very tender to the touch, even though I was diagnosed last August and seem to have a very mild case so far and almost disbelieve my RD when she tells me I will develop full-blown RA in the future.  I am not taking any medication to treat the disease yet, my RD says let's wait, and I have a VERY low RF and anti-CCP. 

But..... I guess what I am trying to say is that even with mild disease, the tell-tale sign is there. 
Here is the abstract:
A new diagnostic sign for rheumatoid arthritis: Avicenna sign
 Department of Rheumatology, Sina Hospital, Tabriz, Iran
KEYWORDS: Avicenna sign • diagnosis • rheumatoid arthritis • shin • tenderness.


Aim: The status of a new sign for diagnosing rheumatoid arthritis is discussed for the first time in this study. It is defined as marked tenderness on the anterior surface of leg (shin) on pressure of about 4 kg by thumb. The sign has been denoted as 'Avicenna sign'.

Methods: All cases were selected by convenient sampling from patients who were referred to two rheumatology clinics in Tabriz, Iran. Sample size was calculated as 618 using Cochran's sampling equation.

Diagnosis of rheumatoid arthritis was made according to American Rheumatism Association criteria. Two physicians were asked to examine the sign on all of the selected patients separately. One of them (a general physician) was not informed about methodology and objectives of the study, whereas a rheumatologist was well informed and he collected data using a written questionnaire.

Test–retest method and discriminant analysis were used to test reliability and validity of the sign for diagnosing rheumatoid arthritis. The effects of intervening variables including osteoporosis and consumption of some medications were controlled employing Chi-square test.

Results: When the general physician examined patients with Avicenna sign to diagnose rheumatoid arthritis, sensitivity and specificity of the sign were reported as 77.1% and 98.4%, respectively. The corresponding values were 81.3% and 98.4%, respectively, when the rheumatologist examined the patients.

Conclusions: This study suggested considerable diagnostic value of the sign for rheumatoid arthritis. Consumption of acetaminophen or NSAIDs had no effect on the status of Avicenna sign while taking gluccocorticoids made it unreliable for diagnostic purposes.

Interesting!  Whereabouts are you tender?  The whole shin?Interesting.  I have had shin pain for years.  The only time it's painful is if I press on my shins.  (I know quit pressing on them)  LindyI suspect this will get the same criticism as the tender point evaluation does in FM. Tenderness is highly variable in placement over time and also by gender.  Lindy, same here --  my shins hurt only when I press them.  
Katie, the pain starts above my ankle and goes about 4 inches up,  and is kind of on the side of the leg bone.  Again, only when I press on it.
Wow- on and off I have shin pain (less often now). Mine is in the front of the shin bone from my ankle to about  6 inches up.  When I complained to my RD he didn't seem to know what to make of it.I get that too.  In fact my shins have been that way for a couple of days now.  But when they don't hurt, they don't hurt even if I press on them.  So i don't know if it''s the same thing as what's described in the article.Linncn- when I have the pain it's not from touching them kinda feels like someone kicked me pretty goodExactly!!Me, too, Like a quick, sharp knfe pain as I'm walking, out of nowhere!  Usually makes me trip up for a step and shout out a quick expletive!!! RDHcRA2008-07-01 11:33:32Mine's not quite like that.  Their isn't really the sharp pain like an actual kick, more like what you would feel after you've been kicked.  It feels like you would expect to see a giant bruise, but it's just red and slightly swollen.  And it hurts to move my foot.Hi!  My shins are extremely sore to the touch, especially the medial aspect of the shin.  It has been horrible, and when my husband goes to massage my feet, I recoil in pain if he tries to rub out my shins.  It is terrible, and we never knew what the heck was wrong with me shins.  I guess now we know.  RA sucks in so many ways.  Sorry for the negativity. btm742008-07-01 12:06:10

Mine is exactly like Linncn's except there is no redness or swelling.

btm74- I have a reflexology appt for my hands and feet on the 12th- hope it isn't painful!


Wasn't I reading on here...or somewhere recently that shin pain can be associated with Vitamin D deficiency? I'll look around and post when I find where I read that. Ya know my BF has been complaining and complaining about how his shin is killing him. I looked at didn't see anything wrong and just thought (to myself of course) that as usual he's being a big ole baby. Hmmm and he had back surgery that didn't help his back pain in December, maybe he's go it too? Hope not. Sorry your legs are hurting, hope you feel better soon.That used to happen to me all the time. My shins were red from the inflammation, and when I walked, it felt like the muscle was going to tear away from the bone. It was awful.
I take 800 mgs of Vitamin D a dayWell, if it is a Vit. D deficiency, I know for a fact, even on all the supplements, that I have that.  Go figure.I too have this and read around the time of being dxd that this was a new symptom. My cat could not even crawl over them with out me coming up off the floor... immediately have your Vit D levels checked... shin tenderness is caused by Vit D deficiency.. have an endocrinologist test it.. to be sure the RIGHT testing is done.
there are correlations between vit D deficiency and RA.......  ETA: I take 1000 mg now.. endo said that women .. especially as we age.. need more than the RDA.
I have beefed up my VitD with the help of my endo.. and I NO longer have shin tenderness..
please.. get tested.
babs102008-07-02 09:23:17hmmm but mine is so off and on.....I thought it was happening more when I was still trying to wear high heels but I've sworn off them.