The gray cortex sign was described as an early sign of stress (fatigue) fractures on conventional radiographs and refers to subtle ill-definition of the cortex.
However, conventional radiography is insensitive for the detection of early-stage fatigue fractures. CT is much more sensitive for detection of bone loss that precedes true fracture 1.
- 1. Gaeta M, Minutoli F, Scribano E, Ascenti G, Vinci S, Bruschetta D, Magaudda L, Blandino A. CT and MR imaging findings in athletes with early tibial stress injuries: comparison with bone scintigraphy findings and emphasis on cortical abnormalities. Radiology. 235 (2): 553-61. doi:10.1148/radiol.2352040406 - Pubmed
- 2. Mulligan ME. The "gray cortex ": an early sign of stress fracture. Skeletal radiology. 1995;24:201-3. Pubmed
- 3. Daffner RH. Anterior tibial striations. AJR. American journal of roentgenology. 143 (3): 651-3. doi:10.2214/ajr.143.3.651 - Pubmed