Stress fractures: definition, diagnosis and treatment

Abstract

Stress fractures were first described in Prussian soldiers by Breithaupt in 1855. They occur as the result of repeatedly making the same movement in a specific region, which can lead to fatigue and imbalance between osteoblast and osteoclast activity, thus favoring bone breakage. In addition, when a particular region of the body is used in the wrong way, a stress fracture can occur even without the occurrence of an excessive number of functional cycles. The objective of this study was to review the most relevant literature of recent years in order to add key information regarding this pathological condition, as an updating article on this topic.

Detecting stress injury (fatigue fracture) in fibular cortical bone using quantitative ultrashort echo time‐magnetization transfer (UTE‐MT): An ex vivo study

“…1,6,13,16,[22][23][24] CT may be less sensitive than conventional radiography for the diagnosis of BSI. However, certain fracture lines can be seen more clearly with CT. 13,16,[22][23][24] Scintigraphy (radionuclide bone scan) has been considered to be the best diagnostic method for BSI, with a reported sensitivity close to 100%, but with high false positive diagnosis. 1,6,13,16,23,24,56 Scintigraphy can show an increase in bone uptake as early as 6 − 72 hours after the onset of pain.…”

“…Conventional radiography, computed tomography (CT), musculoskeletal ultrasonography, scintigraphy and magnetic resonance imaging (MRI) are common techniques to diagnose BSI. 1,6,13,16,[22][23][24] Since the late 1990s, clinical MRI has become the most common modality for the early-stage diagnosis of BSI. 1,6,13,16,[22][23][24][25][26] Clinical T 1and T 2weighted images are recognized as the most practical techniques for the detection of BSI during the first 3 weeks of onset 1,13 through edema detection in periosteum and bone marrow.…”

“…1,6,13,16,[22][23][24] Since the late 1990s, clinical MRI has become the most common modality for the early-stage diagnosis of BSI. 1,6,13,16,[22][23][24][25][26] Clinical T 1and T 2weighted images are recognized as the most practical techniques for the detection of BSI during the first 3 weeks of onset 1,13 through edema detection in periosteum and bone marrow. 1,10,13,27,28 Nevertheless, clinical MRI lacks any quantitative assessment of the injured components of the bone, because normal and injured bones are "invisible" on clinical MRI.…”

The differential diagnosis of metatarsalgia

“…[5] для визначення болю під головками плеснових кісток. Автори, які згодом застосовували термін М, надавали різноманітні морфологічні чинники для виникнення больового синдрому [6][7][8].…”

Bilateral iliac stress fracture in a young male military cadet: report of an unusual case

“…Stress fractures are common in military population. They were first reported in Prussian soldiers' metatarsals by Breithaupt in 1855 as "march fractures" and their radiographic characteristics were described by Stechow in 1897 1 . Stress fractures occur generally due to bone fatigue and there is a clear distinction be made between fatigue and insufficiency fractures 2 .…”