Insufficiency fracture distal tibia

Case contributed by Chris O'Donnell
Diagnosis almost certain


Pain in the ankle for 6 weeks with marked surrounding swelling.

Patient Data

Age: 90 years
Gender: Female

Generalized reduction in bone density consistent with the advanced age and gender of the patient, marked surrounding soft tissue swelling but no fracture (only minor sclerosis in distal tibia).  

One month later


Persistence of soft tissue swelling and development of a sclerotic band in the distal tibia laterally.

Nuclear medicine

Marked increase in vascularity surrounding the ankle with a transverse band of intense isotope accumulation in the distal tibia corresponding to the site of sclerosis on the X-ray.

Case Discussion

Insufficiency fracture in a typical location.

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