Calcaneum and distal tibia stress fractures (MRI)

Case contributed by Dai Roberts


Gaelic football player, recent increase in training frequency. Pain around ankle and hindfoot. Prior syndesmosis tightrope repair.

Patient Data

Age: 25 years
Gender: Male

Linear fractures within the distal tibial metaphysis and posterosuperior aspect of the calcaneum most in keeping with stress fractures. Evidence of prior syndesmotic stabilization. 

The Achilles and long ankle tendons are normal. Normal ankle ligaments allowing for artefact. 

Case Discussion

Stress fractures occur when there is abnormal stress on normal bone.  The distal tibia and posterosuperior aspect of the calcaneum are recognized areas in which these occur, which will often stand out on MRI due to surrounding edema but can be less easy to recognize on radiographs.  

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