MRI Findings of Femoral Diaphyseal Stress Injuries in Athletes

Hwang, Bryan J.; Fredericson, Michael; Chung, Christine B.; Beaulieu, Christopher F.; Gold, Garry E.

doi:10.2214/ajr.185.1.01850166

Cited by 21 publications

(15 citation statements)

References 8 publications

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“…In contrast, insufficiency fractures involve poor bone quality and normal loading. Exercise-induced stress fractures are preferentially located along the medial femur, as a result of excessive medial compression force during weight bearing (8). It is hypothesized that AFFs are the result of failure in bone with abnormal microarchitecture due to increased tensile forces on the lateral femoral side.…”

Section: The Relationship Between Vitamin D Receptor (Vdr) Polymorphimentioning

confidence: 99%

“…It has been suggested that AFFs are stress or insufficiency fractures (5,6). Unlike classical stress fractures that are seen in athletes, it is thought that AFFs originate from the lateral cortex of the femur (8). A lateral localization of AFFs is even required to fulfill the diagnostic criteria as formulated by the American Society for Bone and Mineral Research (ASBMR) (5,6).…”

Section: Introductionmentioning

confidence: 99%

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�Atypical� atypical femur fractures and use of bisphosphonates

Laarschot

Somford

Jager

et al. 2016

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SummaryBackground. Atypical femur fractures (AFFs) present a rare but serious condition associated with use of bisphosphonates. Underlying mechanisms and clinical risk factors remain unclear. According to the diagnostic criteria formulated by the ASBMR, a lateral localization of an AFF is required. Case history. We present a patient who developed bilateral leg pain while using an oral bisphosphonate and aromatase inhibitor in the course of adjuvant treatment for breast cancer. Initially she was diagnosed with bone metastases and received radiotherapy on the right femur. However, the bilateral periosteal reactions of the subtrochanteric femur are highly suggestive of AFFs. Our case meets all criteria for AFF except that she presented with lesions at the medial side of the femur. Therefore they could be best described as "atypical" atypical femur fractures. Discussion. Since the pathogenesis of AFFs is not fully understood, we cannot rule out that AFFs also occur in the medial femur or in other weight-baring bones. Hence we propose that medial stress reactions belong to a spectrum of atypical fractures associated with use of antiresorptive drugs. The localization may depend on yet unknown biomechanical factors.

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Section: The Relationship Between Vitamin D Receptor (Vdr) Polymorphimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

�Atypical� atypical femur fractures and use of bisphosphonates

Laarschot

Somford

Jager

et al. 2016

ccmbm

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“…This injury is often seen in athletes, especially middle-to long-distance runners, who often present with nonspecific hip, groin, or thigh pain, which can cause a delay in diagnosis [58,59]. The athlete may attribute the symptoms to muscle strain and try to run through the pain, which can cause a comminuted subtrochanteric fracture, sometimes occurring in the middle of a race [60,61].…”

Section: Femoral Shaft Stress Fracturementioning

confidence: 99%

“…12A). A radionuclide bone scan shows increased uptake in this region, but MRI has become the study of choice for evaluating this entity [58]. Findings include marrow edema and abnormal periosteal and cortical signal intensity in more advanced cases (Fig.…”

Section: Femoral Shaft Stress Fracturementioning

confidence: 99%

Tip-of-the-Iceberg Fractures: Small Fractures That Mean Big Trouble

Pierce

McCrum

Rozas

et al. 2015

American Journal of Roentgenology

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“…Stage II lesions are partially detached but stable. MR imaging has proven most accurate in doing this (Chung et al 2005). In stage IV lesions, the fragment is displaced or loose within its bed (Bobic 2000).…”

Section: Osteochondritis Dissecans and Osteochondral Lesionsmentioning

confidence: 99%