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Thank you for the opportunity to respond to Dr Dracopoulos. His concern is that we have used stress and fatigue fractures as being mutually exclusive entities. This is not so and in the discussion you will find that we have referred to the fracture affecting this rollerskater as being a stress fracture (used interchangeably with fatigue fracture). This highlights some uncertainty as to the definitions of stress and fatigue fractures.Dracopoulos states 'that stress (fatigue) fractures do not occur in pathological but normal bone'. What of the osteoporotic 65-year-old female with no history of trauma who presents with a stress fracture of the neck of the femur detected on bone scan? What of the football player who fractures his forearm through the site of a previous plate removal following