Longitudinal tibial stress fractures: a report of eight cases and review of the literature

Journal of Computer Assisted Tomography
C M ShearmanC A Boles

Abstract

We present the imaging features of longitudinal stress fractures in eight patients and evaluate the literature to determine which tests are most useful for making this diagnosis. Three musculoskeletal radiologists retrospectively reviewed eight cases of longitudinal tibial stress fractures presenting between 1988 and 1994. Reports on 36 cases, cited in the literature between 1960 and 1996, also were reviewed. Imaging modalities used and characteristic imaging features were noted. Plain radiographs had a characteristic appearance in approximately 28% of patients. Initially, plain films were negative, and in most cases, they eventually showed characteristic radiographic features. However, 25% of cases failed to demonstrate a plain film abnormality, with the diagnosis made by other modalities. CT or MRI is often diagnostic, and longitudinal stress fractures have characteristic imaging features with each modality. While sensitive, bone scan has lower specificity than either CT or MRI. Longitudinal stress fractures have characteristic imaging features, and familiarity with these features is necessary for timely and efficient diagnosis, avoiding morbidity due to delay or use of unnecessary tests.

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Citations

Apr 20, 2005·Skeletal Radiology·Laura M FayadElliot K Fishman
Jun 27, 2013·La Radiologia medica·Michele GaetaFabio Minutoli
Jun 20, 2003·Joint, Bone, Spine : Revue Du Rhumatisme·Martin SoubrierJean Michel Ristori
Sep 3, 2003·Joint, Bone, Spine : Revue Du Rhumatisme·Michel FrancoPhilippe Jaeger
Mar 20, 2008·Sports Medicine·Daniel S MoranEran Hadad
Aug 25, 2006·AJR. American Journal of Roentgenology·Michele GaetaAlfredo Blandino
Feb 24, 2006·The Journal of Orthopaedic and Sports Physical Therapy·Burke GurneyRon Andrews
Nov 1, 2012·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·A M AnimashawunK Ravikumar
Apr 14, 2016·European Journal of Radiology Open·Carlos BilreiroMiguel Oliveira E Castro
Dec 25, 2015·European Journal of Medical Research·Moritz CrönleinChlodwig Kirchhoff
Jul 18, 2002·Radiologic Clinics of North America·Damon J Spitz, Arthur H Newberg
Jul 1, 2010·Sports Health·Daniel BodorMichael E Stadnick
Jul 10, 2009·Clinical Orthopaedics and Related Research·Colm J McMahonMary G Hochman
Feb 24, 2001·The American Journal of Sports Medicine·B P BodenC Jimenez

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