Presentation
Pain and tenderness at the medial proximal tibia. No previous trauma. ?pes anserinus bursitis ?stress fracture
Patient Data
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A transverse fracture of the medial tibial condyle is present, with bone marrow edema and edema in the adjacent soft tissues, including the medial patellar retinaculum and the popliteus muscle belly.
No abnormalities of the pes anserinus tendons. No effusion in the pes anserinus bursa.
No injuries of the medial meniscus.
Case Discussion
Stress fractures of the medial tibial condyle are rare. Like other tibial stress fractures, they are associated with long-distance walking or running.
Due to the location of the pain, they are often misdiagnosed with more common clinical entities, such as medial meniscus injury or pes anserine bursitis, especially when initial radiographs are negative.
MRI is the most accurate modality, depicting the fracture line (especially on T1WI) and adjacent bone marrow edema (on fluid-sensitive sequences).