Presentation
Ongoing knee and proximal leg pain, no history of trauma. Obese.
Patient Data
Minimally impacted transverse oblique fracture through the medial tibial diametaphysis, with cortical interruption and a faint sclerotic line continuing to reach the lateral cortex. Moderate medial compartment osteoarthritis, with mild changes within the patellofemoral joint, both advanced for age.
CT confirms the minimally impacted fracture of the medial tibial diametaphysis, with extension across the posterior tibial cortex. The zigzag fracture line and lack of a single traumatic event make a stress fracture more likely.
Case Discussion
Stress fractures occur when there is abnormal stress on normal bone. A correlating history can help, which will often state a sudden increase in training load or an insidious onset of symptoms. The patient's body habitus will have contributed to the abnormal load through the tibia.
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