What is an easy way to distinguish between shin splints and a stress fracture? Use a tuning fork. The vibration will cause bone pain in the presence of a stress fracture. — Christina Kurkowski, MS, RN, ONC, CNOR, ANP-C, ONP-C, Wausau, Wis. (188-5)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.