Sensitivity and Specificity of Ultrasonography in Early Diagnosis of Metatarsal Bone Stress Fractures: A Pilot Study of 37 Patients

Banal, F.; Gandjbakhch, Frédérique; Foltz, Violaine; Goldcher, Alain; Etchepare, Fabien; Rozenberg, Sylvie; Koeger, A. C.; Bourgeois, Pierre; Fautrel, Bruno

doi:10.3899/jrheum.080657

Cited by 92 publications

(116 citation statements)

References 25 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…Although its chief application in musculoskeletal disorders is the assessment of soft tissues, US can help in detecting SF. Banal et al reported 70% sensitivity for US compared to an MRI for the examination of fractures of the second metatarsal [12]. Several studies have described ultrasonographic findings of SF (11,14).…”

Section: Discussionmentioning

confidence: 99%

Bilateral stress fracture of the tibia diagnosed by ultrasound. A case report

Khy

Wyssa

Bianchi

2012

Journal of Ultrasound

View full text Add to dashboard Cite

KEYWORDSFatigue fracture; Sonography; Ultrasound; Stress fracture.Abstract We report the case of a 35 years old patient presenting with bilateral pain in the medial aspect of both knees. Ultrasound examination revealed hyperechoic appearance of the subcutaneous tissue and periarticular soft tissue bilateral. Color Doppler studies showed significant vascular signals at the surface of the tibial plateaux. US appearance, together with clinical findings, suggested a diagnosis of simultaneous bilateral fatigue fracture. An MRI confirmed the diagnosis and the patient's symptoms resolved with rest. US may be a useful imaging tool in the diagnosis of stress fracture.Sommario Presentiamo il caso di un paziente di 35 anni con dolore bilaterale nella parte mediale delle ginocchia. L'ecografia evidenziava ipoecogenicità del tessuto sottocutaneo e delle parti molli periarticolari bilateralmente. L'esame con color Doppler mostrava significativi segnali vascolari in corrispondenza del piatto tibiale. L'aspetto ecografico, associato ai segni clinici, suggeriva la diagnosi di simultanea frattura da fatica, bilaterale. La risonanza magnetica confermava la diagnosi e i sintomi del paziente regredivano con il riposo. L'ecografia può essere un'utile metodica nella diagnosi frattura da stress. ª

show abstract

Section: Discussionmentioning

confidence: 99%

Bilateral stress fracture of the tibia diagnosed by ultrasound. A case report

Khy

Wyssa

Bianchi

2012

Journal of Ultrasound

View full text Add to dashboard Cite

show abstract

“…14 Since then, US has aided in diagnosing additional metatarsal stress fractures, 8,15,16 detection of other occult fractures in the foot and ankle, 17 stress fractures of the lower limb, 18 and prediction of fracture callus formation with the use of color Doppler US. 19 Furthermore, US has been recommended as a follow-up examination to negative radiography in the diagnostic workup of suspected stress fractures because it may circumvent the need for more costly tests such as MRI and skeletal scintigraphy.…”

Section: Figmentioning

confidence: 99%

“…19 Furthermore, US has been recommended as a follow-up examination to negative radiography in the diagnostic workup of suspected stress fractures because it may circumvent the need for more costly tests such as MRI and skeletal scintigraphy. 8,17 Currently, the following 5 US criteria are used to determine the presence of stress fractures: increased vascularity as demonstrated using color Doppler, periosteal elevation with a cortical break/loss of periosteal contiguity, periosteal reaction and early callus formation, hypoechoic area adjacent to the cortical break (corresponding to hematoma), and overlying soft tissue edema. 8,16,18 In this case, the following US criteria were initially noted: increased vascularity demonstrated with color Doppler, periosteal elevation, and cortical disruption.…”

Section: Figmentioning

confidence: 99%

“…8,17 Currently, the following 5 US criteria are used to determine the presence of stress fractures: increased vascularity as demonstrated using color Doppler, periosteal elevation with a cortical break/loss of periosteal contiguity, periosteal reaction and early callus formation, hypoechoic area adjacent to the cortical break (corresponding to hematoma), and overlying soft tissue edema. 8,16,18 In this case, the following US criteria were initially noted: increased vascularity demonstrated with color Doppler, periosteal elevation, and cortical disruption. During serial US scans, we observed resolution of the hematoma, a decrease in vascularity, and development of a bridging callus over the area of cortical break.…”

Section: Figmentioning

confidence: 99%

“…7 More recently, ultrasonography (US) has been proposed as a reasonable follow-up to negative plain film radiographic results in the workup of a suspected stress fracture; and US criteria have been established that are consistent with and diagnostic of stress fractures. 8 The purpose of this report is to present a case of a fifth metatarsal stress fracture that not only was visualized with US based on these criteria but also was periodically followed with US through symptom resolution.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis and serial sonography of a proximal fifth metatarsal stress fracture

Battaglia

Kaeser

Kettner

2013

Journal of Chiropractic Medicine

View full text Add to dashboard Cite

Objective: The purpose of this report is to describe a fifth metatarsal stress fracture that was not detectable using conventional radiographs and was identified with diagnostic ultrasonography (US), confirmed with computed tomography, and followed through symptom resolution with US. Clinical features: A 68-year-old woman presented to a chiropractic teaching clinic for evaluation of right foot pain. Diagnostic US examination using an 8-to 15-MHz linear array transducer showed increased vascularity, periosteal elevation, and cortical disruption of the proximal diaphysis of the fifth metatarsal suggestive of a stress fracture. The patient was referred to an orthopedic specialist for comanagement. Intervention and outcome: The patient was treated by an orthopedist who confirmed a stress fracture using computed tomography, and she was fit with a short-leg walking boot. Serial US images were obtained to document fracture healing and exclude complications. After 6 months, the patient was asymptomatic and had resumed all of her daily activities. Conclusion: We report a case of a proximal fifth metatarsal stress fracture that was visualized with US and followed through symptom resolution by serial examinations.

show abstract

Stress Fractures of the Calcaneus Diagnosed by Sonography: Report of 8 Cases

Bianchi¹,

Luong²

2017

J of Ultrasound Medicine

View full text Add to dashboard Cite

We present a retrospective review of 8 patients (6 women and 2 men, with an age range of 46-80 years; mean age, 60.2 years) in whom sonography was used to diagnose a calcaneal stress fracture. Sonography was performed because of a clinical suspicion of soft tissue injuries. Two patients were first assessed by standard radiography; for the remaining patients, sonography was the first imaging technique used. Patients were subsequently examined by magnetic resonance imaging, except for 1 patient in whom the diagnosis was made only on a clinical-sonographic correlation. On sonography, there was thickening of the periosteum and subcutaneous edema in all patients; a calcified bone callus was evident in none of the 8 patients. Cortical irregularities were found in 6 of 8 patients. Color Doppler imaging showed local hypervascular changes of the periosteum in all patients. Sonography, together with clinical findings, can be used to diagnose a calcaneal stress fracture. We suggest that sonologists should include a calcaneal stress fracture in their differential diagnosis in cases of mechanical hind foot pain. They must also include, as a part of every sonographic examination of the ankle, an examination of the calcaneus and be aware of the sonographic appearance of stress fractures. If the diagnosis is still uncertain after the sonographic examination, magnetic resonance imaging should be prescribed.

show abstract

Sensitivity and Specificity of Ultrasonography in Early Diagnosis of Metatarsal Bone Stress Fractures: A Pilot Study of 37 Patients

Abstract: In cases of normal radiographs, US is indicated in the diagnosis of metatarsal bone stress fractures, as it is a low cost, noninvasive, rapid, and easy technique with good sensitivity and specificity. From these data, we propose a new imaging algorithm including US.

Cited by 92 publications

References 25 publications

Bilateral stress fracture of the tibia diagnosed by ultrasound. A case report

Bilateral stress fracture of the tibia diagnosed by ultrasound. A case report

Diagnosis and serial sonography of a proximal fifth metatarsal stress fracture

Stress Fractures of the Calcaneus Diagnosed by Sonography: Report of 8 Cases

Contact Info

Product

Resources

About