Insufficiency fracture: Fracture due to physiologic stress on abnormally weak bone
Fatigue fracture: Fracture due to increased stress on normal bone
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Jorge JP et al: Adjacent bi-level bilateral pedicle stress fractures after instrumented posterolateral lumbar fusion-a case report and review of the literature. Eur J Orthop Surg Traumatol. 29(5):1147-51, 2019
Estrada, JADH et al: Bilateral fracture of L5 pedicles in a patient with total disc replacement of L5-S1: a case report. Coluna/Columna [online]. 13(2):153-5, 2014. http://dx.doi.org/10.1590/S1808-18512014130200456
Borg B et al: Pedicle marrow signal hyperintensity on short tau inversion recovery- and t2-weighted images: prevalence and relationship to clinical symptoms. AJNR Am J Neuroradiol. 32(9):1624-31, 2011
El Rachkidi R et al: Atypical bilateral pedicle fracture in long-term bisphosphonate therapy. Spine (Phila Pa 1976). 36(26):E1769-73, 2011
Amari R et al: Fresh stress fractures of lumbar pedicles in an adolescent male ballet dancer: case report and literature review. Arch Orthop Trauma Surg. 129(3):397-401, 2009
Doita M et al: Bilateral pedicle stress fracture in a patient with lumbar spinal stenosis: a case report. J Spinal Disord Tech. 21(7):531-4, 2008
Vialle R et al: Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report. Eur Spine J. 16 Suppl 3:316-7, 2007
Sadiq MZ: Bilateral pedicle stress fracture in the lumbar spine of a sedentary office worker. Eur Spine J. 15 Suppl 5:653-5, 2006
Sairyo K et al: Athletes with unilateral spondylolysis are at risk of stress fracture at the contralateral pedicle and pars interarticularis: a clinical and biomechanical study. Am J Sports Med. 33(4):583-90, 2005
Parvataneni HK et al: Bilateral pedicle stress fractures in a female athlete: case report and review of the literature. Spine (Phila Pa 1976). 29(2):E19-21, 2004
Bose B: Fracture of S1-2 after L4-S1 decompression and fusion. Case report and review of the literature. J Neurosurg. 99(3 Suppl):310-2, 2003
Ha KY et al: Bilateral pedicle stress fracture after instrumented posterolateral lumbar fusion: a case report. Spine (Phila Pa 1976). 28(8):E158-60, 2003
Hollenberg GM et al: Imaging of the spine in sports medicine. Curr Sports Med Rep. 2(1):33-40, 2003
Slipman CW et al: Sacral stress fracture in a female field hockey player. Am J Phys Med Rehabil. 82(11):893-6, 2003
Fourney DR et al: Early sacral stress fracture after reduction of spondylolisthesis and lumbosacral fixation: case report. Neurosurgery. 51(6):1507-10; discussion 1510-1, 2002
Kraft DE: Low back pain in the adolescent athlete. Pediatr Clin North Am. 49(3):643-53, 2002
Reitman CA et al: Lumbar isthmic defects in teenagers resulting from stress fractures. Spine J. 2(4):303-6, 2002
Shah MK et al: Sacral stress fractures: an unusual cause of low back pain in an athlete. Spine. 27(4):E104-8, 2002
Sheehan JP et al: Stress fracture of the pedicle after extensive decompression and contralateral posterior fusion for lumbar stenosis. Report of three cases. Neurosurg Focus. 13(2):E9, 2002
Sirvanci M et al: Pedicular stress fracture in lumbar spine. Clin Imaging. 26(3): 187-93, 2002
Macdessi SJ et al: Pedicle fracture after instrumented posterolateral lumbar fusion: a case report. Spine (Phila Pa 1976). 26(5):580-2, 2001
Guillodo Y et al: Contralateral spondylolysis and fracture of the lumbar pedicle in an elite female gymnast: a case report. Spine (Phila Pa 1976). 25(19):2541-3, 2000
Chong VF et al: Pedicular stress fracture in the lumbar spine. Australas Radiol. 41(3): 306-7, 1997
Heggeness MH et al: The trabecular anatomy of thoracolumbar vertebrae: implications for burst fractures. J Anat. 191 ( Pt 2): 309-12, 1997
Robertson PA et al: Stress fracture of the pedicle. A late complication of posterolateral lumbar fusion. Spine (Phila Pa 1976). 18(7):930-2, 1993
Gunzburg R et al: Stress fracture of the lumbar pedicle. Case reports of "pediculolysis" and review of the literature. Spine (Phila Pa 1976). 16(2):185-9, 1991
Traughber PD et al: Bilateral pedicle stress fractures: SPECT and CT features. J Comput Assist Tomogr. 15(2): 338-40, 1991
Stanley D et al: Contralateral pedicle stress fracture. An unusual complication of laminectomy. Spine (Phila Pa 1976). 15(6):598-9, 1990
Garber JE et al: Unilateral spondylolysis and contralateral pedicle fracture. Spine (Phila Pa 1976). 11(1):63-6, 1986
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Synonyms
Pediculolysis
Definitions
Insufficiency fracture: Fracture due to physiologic stress on abnormally weak bone
Fatigue fracture: Fracture due to increased stress on normal bone
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Jorge JP et al: Adjacent bi-level bilateral pedicle stress fractures after instrumented posterolateral lumbar fusion-a case report and review of the literature. Eur J Orthop Surg Traumatol. 29(5):1147-51, 2019
Estrada, JADH et al: Bilateral fracture of L5 pedicles in a patient with total disc replacement of L5-S1: a case report. Coluna/Columna [online]. 13(2):153-5, 2014. http://dx.doi.org/10.1590/S1808-18512014130200456
Borg B et al: Pedicle marrow signal hyperintensity on short tau inversion recovery- and t2-weighted images: prevalence and relationship to clinical symptoms. AJNR Am J Neuroradiol. 32(9):1624-31, 2011
El Rachkidi R et al: Atypical bilateral pedicle fracture in long-term bisphosphonate therapy. Spine (Phila Pa 1976). 36(26):E1769-73, 2011
Amari R et al: Fresh stress fractures of lumbar pedicles in an adolescent male ballet dancer: case report and literature review. Arch Orthop Trauma Surg. 129(3):397-401, 2009
Doita M et al: Bilateral pedicle stress fracture in a patient with lumbar spinal stenosis: a case report. J Spinal Disord Tech. 21(7):531-4, 2008
Vialle R et al: Acute L5 pedicle fracture and contralateral spondylolysis in a 12-year-old boy: a case report. Eur Spine J. 16 Suppl 3:316-7, 2007
Sadiq MZ: Bilateral pedicle stress fracture in the lumbar spine of a sedentary office worker. Eur Spine J. 15 Suppl 5:653-5, 2006
Sairyo K et al: Athletes with unilateral spondylolysis are at risk of stress fracture at the contralateral pedicle and pars interarticularis: a clinical and biomechanical study. Am J Sports Med. 33(4):583-90, 2005
Parvataneni HK et al: Bilateral pedicle stress fractures in a female athlete: case report and review of the literature. Spine (Phila Pa 1976). 29(2):E19-21, 2004
Bose B: Fracture of S1-2 after L4-S1 decompression and fusion. Case report and review of the literature. J Neurosurg. 99(3 Suppl):310-2, 2003
Ha KY et al: Bilateral pedicle stress fracture after instrumented posterolateral lumbar fusion: a case report. Spine (Phila Pa 1976). 28(8):E158-60, 2003
Hollenberg GM et al: Imaging of the spine in sports medicine. Curr Sports Med Rep. 2(1):33-40, 2003
Slipman CW et al: Sacral stress fracture in a female field hockey player. Am J Phys Med Rehabil. 82(11):893-6, 2003
Fourney DR et al: Early sacral stress fracture after reduction of spondylolisthesis and lumbosacral fixation: case report. Neurosurgery. 51(6):1507-10; discussion 1510-1, 2002
Kraft DE: Low back pain in the adolescent athlete. Pediatr Clin North Am. 49(3):643-53, 2002
Reitman CA et al: Lumbar isthmic defects in teenagers resulting from stress fractures. Spine J. 2(4):303-6, 2002
Shah MK et al: Sacral stress fractures: an unusual cause of low back pain in an athlete. Spine. 27(4):E104-8, 2002
Sheehan JP et al: Stress fracture of the pedicle after extensive decompression and contralateral posterior fusion for lumbar stenosis. Report of three cases. Neurosurg Focus. 13(2):E9, 2002
Sirvanci M et al: Pedicular stress fracture in lumbar spine. Clin Imaging. 26(3): 187-93, 2002
Macdessi SJ et al: Pedicle fracture after instrumented posterolateral lumbar fusion: a case report. Spine (Phila Pa 1976). 26(5):580-2, 2001
Guillodo Y et al: Contralateral spondylolysis and fracture of the lumbar pedicle in an elite female gymnast: a case report. Spine (Phila Pa 1976). 25(19):2541-3, 2000
Chong VF et al: Pedicular stress fracture in the lumbar spine. Australas Radiol. 41(3): 306-7, 1997
Heggeness MH et al: The trabecular anatomy of thoracolumbar vertebrae: implications for burst fractures. J Anat. 191 ( Pt 2): 309-12, 1997
Robertson PA et al: Stress fracture of the pedicle. A late complication of posterolateral lumbar fusion. Spine (Phila Pa 1976). 18(7):930-2, 1993
Gunzburg R et al: Stress fracture of the lumbar pedicle. Case reports of "pediculolysis" and review of the literature. Spine (Phila Pa 1976). 16(2):185-9, 1991
Traughber PD et al: Bilateral pedicle stress fractures: SPECT and CT features. J Comput Assist Tomogr. 15(2): 338-40, 1991
Stanley D et al: Contralateral pedicle stress fracture. An unusual complication of laminectomy. Spine (Phila Pa 1976). 15(6):598-9, 1990
Garber JE et al: Unilateral spondylolysis and contralateral pedicle fracture. Spine (Phila Pa 1976). 11(1):63-6, 1986
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