The diagnosis of stress fractures in athletes
M. D. Devereaux, G. R. Parr, S. M. Lachmann, P. Page-Thomas and B. L. Hazleman
Eighteen patients with shin pain that was clinically considered to be
caused by a stress fracture of the tibia or fibula underwent radiological,
thermographic, and scintigraphic studies and a test of ultrasound-induced
pain. When initially seen, 15 had stress fractures confirmed by
scintigraphy. Of these, 12 had abnormal thermograms, eight had positive
test results for ultrasound-induced pain, and seven had abnormal
radiographs. Thermography used alone seemed to be a safe, rapid means of
diagnosis for stress fractures in the tibia or fibula and was not found to
be related to symptom duration. In the radiologically normal group of
stress fractures, four (50%) had positive test results for ultrasound
stress tests and normal thermograms. The combination of these two tests
should provide an early method of detecting stress fractures in the tibia
and fibula, thereby avoiding scintiscans in some athletes.
