The Pathophysiology, Diagnosis, and Management of Stress Fractures in Postmenopausal Women

Pegrum, James; Crisp, Tom; Padhiar, Nat; Flynn, J. Jay

doi:10.3810/psm.2012.09.1978

Cited by 12 publications

(10 citation statements)

References 126 publications

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“…For this purpose, a pedobarographic test was carried out under both static and dynamic conditions (Figure 10 MH-internal part of the tarsus/LH-external part of the tarsus: allows the reading of pressure, with the correlation of results based on the outcomes of anthropometric tests of valgus/varus tarsus deformity/ tarsus instability, both while standing and walking MF-metatarsus: allows the pressure on the metatarsus to be assessed; this is especially important in assessing pressure during walking M 1-5-pressure on the metatarsophalangeal joints: allows conclusions to be drawn on the functionality of the transverse arch T1-pressure on the great toe and T2-5-pressure on the toes 2-5 e results of the examination show a significant overload of the forefoot, with fractures and degradation of the 3rd metatarsal head (M3 meta surface). It is noteworthy Pain Research and Management that the compensatory processes that reduce pain while standing do not activate while walking (despite persistent pain), while standing the foot is stabilized by the tarsometatarsal joints (TMTJ), which consequently makes the second and third metatarsal bones susceptible to fractures as a result of stress [69][70][71]. Patient no.…”

Section: Pain Research and Managementmentioning

confidence: 99%

Prophylaxis of Pain and Fractures within Feet in the Course of Osteoporosis: The Issue of Diagnosing

Bitenc-Jasiejko

Konior

Gonta

et al. 2020

Pain Research and Management

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Background. Considering the enormous risk of fractures in the course of osteoporosis in the area of the feet, an important aspect of prophylaxis is periodic and, in special cases, ongoing monitoring of defects and deformations as well as pressure distribution. The purpose of this article is to indicate the role of the examination of posture and pressure distribution during standing, postural balance, and gait, in the prevention of fatigue fractures in the course of osteoporosis, based on the literature review and examples of patients. Methods. The manuscript consists of two parts; it has a review-analytical character. The first part reviews the literature. The data were obtained using the MEDLINE (PubMed), as well as Cochrane and Embase databases. The database review was carried out focusing mainly on English-language publications, while taking into account the topicality of scientific and research works in the area of osteoporosis. The problem of multiaspects in the area of bone density was pointed out. Considering the above, in the second part, the authors analyzed 11 exemplary patients with osteoporosis, referring to the assessment of foot and lower limb defects using traditional posturological methods and including pedobarography to diagnostic procedures that are used in the assessment of pressure distribution, standing and moving, and an attempt to balance. Results. Analysis of the research and scientific literature proved the lack of unambiguous diagnostic procedures of the locomotor system recommended for the prevention of fatigue fractures in the course of osteoporosis. The main diagnostic recommendations are imaging tests (most often X-ray), which are recommended in the case of specific clinical symptoms. The analysis of exemplary patients with osteoporosis showed numerous disorders in the distribution of pressure in the plantar part of the feet, which are related, among other things, with their individual defects and lower limbs. Conclusions. Detailed posture diagnostics and gait estimation, along with the analysis of pressure distribution within the feet are a very important aspect of the prevention of structural degradation and fatigue fractures within the feet. An important postulate for further research and scientific work is the elaboration of the procedures that will serve the preventive diagnostics of the locomotor system, aimed at early detection of threats of fatigue fractures.

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Section: Pain Research and Managementmentioning

confidence: 99%

Prophylaxis of Pain and Fractures within Feet in the Course of Osteoporosis: The Issue of Diagnosing

Bitenc-Jasiejko

Konior

Gonta

et al. 2020

Pain Research and Management

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“…Computer tomography imaging is more sensitive than plain X-Ray but is expensive and should be limited in use because of ionising radiation, (Papalada et al 2012). Early diagnosis enables appropriate management strategies are put in place including activity modification preventing worsening of the pathology (Bianchi 2014, Pegrum et al 2012. MSKUSI findings with stress fractures include periosteal thickening, calcified bone callus, cortical irregularities, subcutaneous oedema and hypervascularity with Colour Doppler, (Bianchi 2014).…”

Section: 3: Modern Day Musculoskeletal Ultrasound Imaging Applicationsmentioning

confidence: 99%

Musculoskeletal ultrasound imaging - An exploration of physiotherapists' interests and use in practice

Innes

Jackson

2019

Musculoskeletal Science and Practice

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Acknowledgements ii Chapter 1 Background to the Study 1.1 Introduction 1 1.2 History of Musculoskeletal Ultrasound 1 1.3 Modern Day Musculoskeletal Ultrasound Imaging Applications 4 1.4 Professional Application of Musculoskeletal Ultrasound 9 1.5 Musculoskeletal Ultrasound Education and Regulation Chapter 2 Literature Review 2.1 The Application of Musculoskeletal Ultrasound by Physiotherapists 2.2 Search Strategy 2.3 Literature reviewing the role of Musculoskeletal Ultrasound for Physiotherapists 2.4 Literature that reviews the role of Musculoskeletal Ultrasound for unspecified health care professionals or those who are not physiotherapists 2.5 Literature that reviews the role of Musculoskeletal Ultrasound as an Outcome Measure in Research Studies.

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“…20 Both pre- and postmenopausal women are at risk. 20,26 Extrinsic factors include training intensity, training surfaces, diet, and footwear. 11…”

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confidence: 99%

Physiological Factors of Female Runners With and Without Stress Fracture Histories: A Pilot Study

Johnston

Dempsey

Gilman

et al. 2020

Sports Health: A Multidisciplinary Approach

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Background: Female runners are at increased risk of stress fractures (SFs) compared with men. Literature is lacking with regard to best practice for preventing and treating SFs in women. The purpose of the study was to compare physiological measures and running-related factors between women of various ages and running abilities with and without a history of running-related SFs. Hypothesis: Women with and without SF histories will differ with regard to medical and menstrual history, bone health, body composition, nutrition, and running history. Study Design: Prospective cohort study. Level of Evidence: Level 2. Methods: A total of 20 female runners with SF histories were matched based on age and running distance with 20 women without SF histories. Data included medical, menstrual, running, injury, and nutritional histories; blood histology related to nutritional, hormonal, and bone-related risk factors; and bone density, fat, and lean tissue using dual energy x-ray absorptiometry. Paired t tests were used to examine differences between women with and without SF histories, and Spearmen correlations were conducted to examine relationships between physiological factors. Results: Women with SF histories had lower hip bone mineral density compared with women without SF histories ( P < 0.05). SF history was moderately correlated with menstrual changes during increased training times ( r = 0.580; P < 0.0001) but was not correlated with any other physiological factor. There was a moderate correlation within the SF group ( r = 0.65; P = 0.004) for bone markers for resorption and formation both increasing, indicating increased bone turnover. Conclusion: Female runners with low hip bone mineral density, menstrual changes during peak training, and elevated bone turnover markers may be at increased risk of SF. Clinical Relevance: Female runners need routine screening for risks associated with SF occurrence. As bone mineral density and bone turnover markers are not routinely assessed in this population, important risk factors may be missed.

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The Pathophysiology, Diagnosis, and Management of Stress Fractures in Postmenopausal Women

Cited by 12 publications

References 126 publications

Prophylaxis of Pain and Fractures within Feet in the Course of Osteoporosis: The Issue of Diagnosing

Prophylaxis of Pain and Fractures within Feet in the Course of Osteoporosis: The Issue of Diagnosing

Musculoskeletal ultrasound imaging - An exploration of physiotherapists' interests and use in practice

Physiological Factors of Female Runners With and Without Stress Fracture Histories: A Pilot Study

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