Proximal tibial stress fractures

Case contributed by Domenico Nicoletti
Diagnosis certain

Presentation

Left knee pain on the medial side after an episode of prolonged walking in history of psoriatic arthritis treated with oral methotrexate and oral prednisone for the last six years. No trauma.

Patient Data

Age: 35 years
Gender: Male

Left knee joint

mri

In the medial proximal tibia STIR and T1 images show a low-signal line surrounding bone marrow edema. The menisci, cruciate ligaments and collaterals are normal. There’s no articular effusion.

Case Discussion

Prolonged usage of methotrexate and corticosteroids can predispose to stress fracturesOsteopenia caused by corticosteroid treatment, or relative immobility is a predisposing factor.

 

Radiographer: TSRM Fabio Imola

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