Tibial stress fracture

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Knee pain

Patient Data

Age: 35 years
Gender: Male
mri

A transverse fracture of the posteromedial aspect of proximal tibial metaphysis, with bone marrow edema.

Case Discussion

This patient experienced pain while a routine military march. Stress fractures in the lower extremity account for 90% of all stress fractures, with the tibia being the most common followed by navicular and metatarsals then the femur and pelvis 1. Most tibial stress fractures occur posteromedially (PM type) 2. It is considered a low-risk fracture according to its likelihood of uncomplicated healing with conservative therapy. MRI is the best modality for detection, depicting the fracture line on T1WI and adjacent bone marrow edema on fluid-sensitive sequences.

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