Multiple stress fractures: army recruit

Case contributed by Dr Chris O'Donnell

Presentation

Army recruit on basic training presents with multiple aches and pains in the lower limbs.

Patient Data

Age: 19
Gender: Female

Bone scan (Tc99m MDP)

Modality: Nuclear medicine

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.

Case Discussion

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).

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Case Information

rID: 37723
Case created: 19th Jun 2015
Last edited: 21st Nov 2015
Inclusion in quiz mode: Included

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