Case Report : Multiple Stress Fractures (hamate, triquetrum, 2nd, 3rd, and 4th Metacarpal bones) in an Amateur Tennis Player

Abstract

Background: upper extremity stress fractures are infrequent events in tennis sport. According to our literature, we have only identified 6 case reports of upper limb stress fractures among amateur or professional tennis players. To the best of our knowledge, this is the only case report where stress fractures occur in: hamate, triquetrum, 2nd, 4th, and 5th metacarpal bones simultaneously. 
 Case presentation: 27 years old lady, presented with acute burning pain at the base of her right thumb. There was not a history of direct trauma. Her symptoms start to appear after 3 days of playing tennis. Physical examination was negative for tenderness, swelling and erythema. The rheumatoid factor was elevated (20.3 iu/ml). the diagnosis of multiple stress fractures was made by the suggestive MRI findings. 
 Conclusion: Although stress fractures of the upper limbs are not common, it is of a great value to keep the clinical suspicion high towards it. Especially in amateur or professional athletes with persistent or worsening symptoms. The best modality to confirm such fractures is MRI.