Sonographic findings in stress fractures of the lower limb: preliminary findings

Bodner, Gerd; Stöckl, Bernhard; Fierlinger, Anke; Schocke, Michael; Bernathova, Maria

doi:10.1007/s00330-004-2525-8

Cited by 65 publications

(45 citation statements)

References 12 publications

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“…Although the examination showed a normal bone cortex without signs of focal interruption, the evident thickening and hyperemia of the periosteum and adjacent soft tissue edema were consistent with the diag- nosis. The US appearance in our patient closely resembles that described by Bodner 13 in metatarsal stress fractures. We noted in our patient an excellent correlation between the US and MRI findings.…”

Section: Discussionsupporting

confidence: 76%

Insufficiency fracture of the calcaneum: Sonographic findings

Arni¹,

Lambert²,

Delmi³

et al. 2009

J of Clinical Ultrasound

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We present a case of insufficiency fracture (IF) of the calcaneum diagnosed by sonography (US). An 83-year-old woman consulted because of pain and swelling of the left heel without history of trauma. Standard radiographs showed osteoporosis without fracture. US revealed thickening of the calcaneal periosteum associated with edema of the adjacent soft tissues. Color Doppler imaging showed marked increased vascularity of the periosteum. US changes, together with the clinical and radiographic findings, were consistent with an IF of the calcaneum that was confirmed by MRI. The patient was treated successfully by conservative treatment. In the proper clinical setting, US can suggest the diagnosis of IF of the calcaneum.

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Section: Discussionsupporting

confidence: 76%

Insufficiency fracture of the calcaneum: Sonographic findings

Arni¹,

Lambert²,

Delmi³

et al. 2009

J of Clinical Ultrasound

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“…Most articles discussing the US appearance of SF have been focused on metatarsals [12,16]. Reports on SF affecting other bones are scanty [6].…”

Section: Discussionmentioning

confidence: 99%

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

Khy

Wyssa

Bianchi

2012

Journal of Ultrasound

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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

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“…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: 90%

“…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%

Diagnosis and serial sonography of a proximal fifth metatarsal stress fracture

Battaglia

Kaeser

Kettner

2013

Journal of Chiropractic Medicine

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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.

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Sonographic findings in stress fractures of the lower limb: preliminary findings

Cited by 65 publications

References 12 publications

Insufficiency fracture of the calcaneum: Sonographic findings

Insufficiency fracture of the calcaneum: Sonographic findings

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

Diagnosis and serial sonography of a proximal fifth metatarsal stress fracture

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