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    Go to the top of the page   ID: 20030603161946 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Stress fracture of the proximal tibia
    Dirk Schaper, V Hofmann. Stress fracture of the proximal tibia. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030603161946


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper, V. Hofmann (Halle/S.)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    8 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    Leg-Bones  

     
     Pediatric Radiology CasesMost likely etiology:

    physical  

     
     Pediatric Radiology CasesHistory:

    8 year old turk girl with pain in the right tibia for about 14 days. No trauma could be remembered. No nightly pain. When stressed, pain began and worsening. Discrete pasty swelling over the right proximal tibia. Local pain on pressure, no redness. No inflammatory/infectious clinical signs.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-ray 1: Lower thigh in two planes, no signs of fracture, discrete opaque bands in the proximalen tibia.






    X-Ray 2 <- view X-Ray 2

    X-ray 2: Lower thigh a. p.: After 14 more days, spindle-shaped callous, horizontal opaque band with dispersed bone structure






    MRI 1 <- view MRI 1

    MRT 1: In the T1 weighted image, expanded zone of reduced signal, inhomogenic spotty signal reduction, strongly inhomogenic signal increase in T2. Hypodense interruption of the bone's contour. Distinct soft-tissue edema.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Osteomyeltitis, Bone tumor  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    After bed rest, condition improved. No further symptoms. Normal gait.

    A stress fracture in children is rather uncommon. The tibia is often seen, followed by the mid-foot bones, femur, fibula and pelvis. This is more common in females. Typically, the slow progression of pain over a longer period of time is seen. Mostly athletes are afflicted.
    X-ray diagnostics with conventional images is often not sufficient, especially since Osteomyelitis and bone tumors must be excluded differentially. An MRI makes sense and allows staging.
    Therapy depends on the degree of the damage, the time of diagnosis as well as the localization. It spans from bed-rest to surgical repair.  

     
     Pediatric Radiology CasesComments of the author about the case:

    Because of the clinical and laboratory course as well as the obvious placement as a Grade 4 lesion in MRI, we found this to be a stress fracture and treated it conservatively.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Fredericson, M., Bergmann,A.G., Hoffmann,K.L. et al.
    Tibial stress reaction in runners. Correlation of clinical symptoms and scintigraphy with a new magnetic resonance imaging grading system.
    Am J Sports Med 23 (1995) 472-481

    2. Medline: Medline
    de la Cuadra, P., Albinana,J.
    Pediatric stress fractures
    Int Orthop 2000;24(1):47-9

    3. Medline: Medline
    Mitchell,A.D., Grimer,R.J., Davies,A.M.
    Double-stress fracture of the tibia in a ten-year-old child.
    J Pediatr Orthop B 1999 Jan;8(1):67-8  

     
     Pediatric Radiology CasesKeywords:

    Stress fracture, swelling, increasing leg pain, fracture, proximal tibia, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper, V Hofmann. Stress fracture of the proximal tibia. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030603161946  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Leg-Bones
    or in the region: Leg
    or in the tissue/organ: Bones
    or with the etiology: physical
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Stress fracture of the proximal tibia
    Dirk Schaper, V Hofmann. Stress fracture of the proximal tibia. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030603161946


     

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    Stress fracture of the proximal tibia
    Other cases by these authors:

    Search Dirk Schaper in Medline Dirk Schaper (43)   
    Search V. Hofmann  in Medline V. Hofmann (17)   

    Stress fracture of the proximal tibia  
     
    Stress fracture of the proximal tibia
    Dirk Schaper, V Hofmann. Stress fracture of the proximal tibia. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030603161946


     

    Which diagnosis have other collegues guessed?


    • Osteomyelitis
      Votes: 3 (18 %)


    • Ewing sarcoma
      Votes: 3 (18 %)


    • Stress fracture
      Votes: 8 (50 %)


    • Enchondroma
      Votes: 1 (6 %)


    • Hemangioma
      Votes: 1 (6 %)



        Total answers: 16

     
    Stress fracture of the proximal tibia
    Dirk Schaper, V Hofmann. Stress fracture of the proximal tibia. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030603161946


     

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    Stress fracture of the proximal tibia
    Dirk Schaper, V Hofmann. Stress fracture of the proximal tibia. PedRad [serial online] vol 3, no. 6.
    URL: www.PedRad.info/?search=20030603161946


     




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