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Anterior tibial stress fractures can have a particularly poor prognosis and can require surgery. On radiographic imaging, these stress fractures are referred to as the "dreaded black line." [5] When compared to other stress fractures, anterior tibial fractures are more likely to progress to complete fracture of the tibia and displacement. [4]
A bone scan or bone scintigraphy / s ɪ n ˈ t ɪ ɡ r ə f i / is a nuclear medicine imaging technique used to help diagnose and assess different bone diseases. These include cancer of the bone or metastasis, location of bone inflammation and fractures (that may not be visible in traditional X-ray images), and bone infection (osteomyelitis).
Multidetector computed tomography (MDCT) is a highly valuable imaging tool for the diagnosis of occult fractures. CT has several advantages including short acquisition time (compared to MRI), the ability to acquire volumetric and isotropic image data sets, the opportunity to reconstruct multiplanar reformations in any arbitrary plane, and excellent spatial resolution.
Sports involving repetitive or forceful hyperextension of the spine, especially when combined with rotation are the main mechanism of injury for spondylolysis. The stress fracture of the pars interarticularis occurs on the side opposite to activity. For instance, for a right-handed player, the fracture occurs on the left side of the vertebrae. [5]
Other potential causes include stress fractures, compartment syndrome, nerve entrapment, and popliteal artery entrapment syndrome. [18] If the cause is unclear, medical imaging such as a bone scan or magnetic resonance imaging (MRI) may be performed. [3] Bone scans and MRI can differentiate between stress fractures and shin splints. [12]
In patients younger than 12, wrist fractures cause specific alterations at the surface of the bone (bulge, angulation, offset or fracture gap), and through diagnosis and treatment can be identified without X-ray imaging. [14] Intra-articular fractures are rare and require X-ray imaging. The standard procedure is the wrist SAFE algorithm. [15]
Nevertheless, MRI has replaced scintigraphy in the diagnosis of most of these conditions. An example is stress or insufficiency fractures: increased uptake is usually present in around 80% of fractures within 24 h, and 95% of fractures reveal activity by 72 h following trauma, showing an overall sensitivity of 93% and specificity of 95%.
Medial tibial stress syndrome: Pain occurs over the shin bone (the tibia) with running or other sport-related activity. [17] Fibular and tibial stress fracture: Non-displaced microscopic fracture of the fibular and tibia occurs in many athletes, especially runners, and also in non-athletes who suddenly increase their activity level. [18]