Introduction: Fatigue fractures are secondary to excessive, unusual, repeated mechanical stress, occurring on healthy bone. Bone scintigraphy (BS) with 99mTc-HMDP is an excellent means of diagnosis. We report a case of stress fracture of the calcaneus with scintigraphic diagnosis, in a marathon runner. Patient and Methods: He is a 40-year-old athlete in overtraining with right calcaneal pain on running, intense at first, moderate in the middle and then persistent after exercise. The interrogation found no trauma to the right foot and the x-ray of the foot was without abnormality. The so 3 phases were performed following an injection of 564 MBq of 99mTc-HMDP, with a SPECT gamma camera. Results: Bone scintigraphy found in the early phase, hyper-perfusion and hyper-fixation of the right calcaneal region compared to its left counterpart and in the bone phase persistence of focal hyperfixation opposite the right calcaneus. This scintigraphic aspect of the right calcaneus in an overtrained marathon runner, in a painful context and in front of a normal X-ray, made us evoke a fracture of fatigue. A complementary CT scan performed two days after the BS was without abnormality. Conclusion: Fatigue fractures are micro-fractures generally not noticed on radiography and CT. BS due to its high sensitivity is an excellent or the best tool for the early diagnosis of stress fractures.

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Objective: The aim of this study was to describe the stages of learning Kohonen's self-organizing maps applied to scintigraphy imaging in order to perform classification for medical diagnostic aid. Method: To achieve these goals, the neurons, arranged on a regular grid, are connected to each other by a neighbor relationship, which creates the topology of the map. The input layer consisted of pixels from the scintigraphy images. Results: During the iteration rounds of learning, we have seen a deployment of neurons on the nodes of the map that becomes more and more important. And it is the same for the winning neurons. After 750 iterations, the Davies Bouldin index attests to the end of the training with a quantization error that goes from 0.175 at the beginning of the training to 0.0225 at the end of the training. After this study, we find that neurons 41, 62, 121, 101 and 145 have captured most of the data with a peak uptake achieved by neuron 41 which has captured 1048 data. This individualizes the class of high intensities undoubtedly corresponding to metastatic hyperfixations. Conclusion: This innovative method could undoubtedly be integrated into the link in the chain highlighting periarticular metastases in developing countries, most of which do not have a SPECT-CT.