Bone Stress Injuries

Gabrielle Bergman1, Timothy R. Jones1

1 Stanford University Medical Center, Stanford, California
Publication Name:  Current Protocols in Magnetic Resonance Imaging
Unit Number:  Unit A24.1
DOI:  10.1002/0471142719.mia2401s03
Online Posting Date:  February, 2002
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This unit outlines basic MRI protocols for evaluating the most common bone stress injuries including those of the tibia, femoral neck, femoral shaft, metatarsal, and navicular bone. The protocols concentrate on the lower extremity, as the majority of stress injures occur in this region. These protocols were developed using a 1.5 T system (Signa, General Electric Medical Systems). However, the sequences described could be adapted to low‐ or mid‐field scanners using STIR (short tau inversion recovery) sequences to acquire the T2‐weighted images. This technique would thus require longer scan times and lower resolution matrices.

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Table of Contents

  • Basic Protocol 1: Tibial Stress Injuries
  • Basic Protocol 2: Femoral Neck and Femoral Shaft Stress Injuries
  • Basic Protocol 3: Imaging of Metatarsal Stress Injuries
  • Basic Protocol 4: Imaging of Navicular Stress Injuries
  • Commentary
  • Literature Cited
  • Figures
  • Tables
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Literature Cited

Literature Cited
   Bergman, A.G. and Fredericson, M. 1999. MR imaging of stress reactions, muscle injuries, and other overuse injuries in runners. MRI Clinics of North America. 7:151‐174.
   Daffner, R.H. and Pavlov, H. 1992. Stress fractures: Current concepts. A.J.R.. Am. J. Roentgenol. 159:245‐252.
   Floyd, W.N., Butler, J.E., Clanton, T., Kim, E.E., and Pjura, G. 1987. Roentgenologic diagnosis of stress fractures and stress reactions. South. Med. J. 80:433‐439.
   Fredericson, M., Bergman, A.G., Hoffman, K.L., and Dillingham, M.S. 1995. Tibial stress reaction in runners: Correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system. Am. J. Sports Med. 23:472‐481.
   Hulkko, A. and Orava, S. 1987. Stress fractures in athletes. Int. J. Sports Med. 8:221‐226.
   Khan, K.M., Brukner, P.D., and Kearney, C. 1994. Tarsal navicular stress fracture in athletes. Sports Med. 17:65‐76.
   Lee, J.K. and Yao, L. 1988. Stress fractures: MR imaging. Radiology 169:217‐220.
   Matheson, G.O., Clement, D.B., McKenzie, D.C., Taunton, J.E., Lloyd‐Smith, D.R., and MacIntyre, J.G. 1987. Stress fractures in athletes: a study of 320 cases. Am. J. Sports Med. 15:46‐58.
   Milgrom, C., Chisin, R., Giladi, M., Stein, M., Kashtan, H., Margulies, J., and Atlan, H. 1984. Negative bone scans in impending tibial stress fractures: A report of three cases. Am. J. Sports Med. 12:488‐491.
   Pavlov, H., Torg, J.S., and Freiberger, R.H. 1983. Tarsal navicular stress fractures: Radiographic evaluation. Radiology 148:641‐645.
   Roub, L.W., Gumerman, L.W., and Hanley, E.N. 1979. Bone stress: A radionuclide imaging perspective. Radiology 132:431‐438.
   Shellock, F.G. 1996. Pocket Guide to MR Procedures and Metallic Objects. Lippincott‐Raven, Philadelphia.
   Shin, A.Y., Morin, W.D., Gorman, J.D., Jones, S.B., and Lapinsky, A.S. 1996. The superiority of magnetic resonance imaging in differentiating the cause of hip pain in endurance athletes. Am. J. Sports Med. 24:168‐176.
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