Multiple stress fractures: army recruit
Army recruit on basic training presents with multiple aches and pains in the lower limbs.
Bone scan (Tc99m MDP)
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Multiple foci of isotope accumulation in the right mid femur, left mid tibia and right base of 1st metatarsal. Note also further diffuse linear accumulation along the shafts of both femora and tibiae in keeping with periostitis.
Stress fractures occur as a result of excessive forces on normal bones as compared with insufficiency fractures that occur with normal forces on weak bones. Armed forces recruit training is clearly intense with the potential for stress injuries to the lower limbs as in this case (so called "march" fractures).
- 1. Milgrom C, Giladi M, Stein M et-al. Stress fractures in military recruits. A prospective study showing an unusually high incidence. J Bone Joint Surg Br. 1985;67 (5): 732-5. Pubmed citation