Stress fracture: chronic, repetitive injury that leads to incomplete or complete fracture
Insufficiency fracture: fracture due to normal stress on weak bone
Fatigue fracture: fracture due to abnormal stress on normal bone; in practice, there is often overlap between fatigue and insufficiency fractures
Pathologic fracture: fracture due to underlying tumor or infection
Stress injury: bone marrow edema or long-segment periosteal reaction without fracture line; can progress to fracture
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Hodes A et al: Metatarsalgia. Radiol Clin North Am. 56(6):877-92, 2018
Mandell JC et al: Stress fractures of the foot and ankle, part 2: site-specific etiology, imaging, and treatment, and differential diagnosis. Skeletal Radiol. 46(9):1165-86, 2017
Mandell JC et al: Stress fractures of the foot and ankle, part 1: biomechanics of bone and principles of imaging and treatment. Skeletal Radiol. 46(8):1021-9, 2017
Welck MJ et al: Stress fractures of the foot and ankle. Injury. 48(8):1722-6, 2015
Yu SM et al: MRI of isolated cuboid stress fractures in adults. AJR Am J Roentgenol. 201(6):1325-30, 2013
Brockwell J et al: Stress fractures of the foot and ankle. Sports Med Arthrosc. 17(3):149-59, 2009
Mann JA et al: Evaluation and treatment of navicular stress fractures, including nonunions, revision surgery, and persistent pain after treatment. Foot Ankle Clin. 14(2):187-204, 2009
Burne SG et al: Tarsal navicular stress injury: long-term outcome and clinicoradiological correlation using both computed tomography and magnetic resonance imaging. Am J Sports Med. 33(12):1875-81, 2005
Franco M et al: An uncommon cause of foot pain: the cuboid insufficiency stress fracture. Joint Bone Spine. 72(1):76-8, 2005
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References
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Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
Stress fracture: chronic, repetitive injury that leads to incomplete or complete fracture
Insufficiency fracture: fracture due to normal stress on weak bone
Fatigue fracture: fracture due to abnormal stress on normal bone; in practice, there is often overlap between fatigue and insufficiency fractures
Pathologic fracture: fracture due to underlying tumor or infection
Stress injury: bone marrow edema or long-segment periosteal reaction without fracture line; can progress to fracture
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Selected References
Hodes A et al: Metatarsalgia. Radiol Clin North Am. 56(6):877-92, 2018
Mandell JC et al: Stress fractures of the foot and ankle, part 2: site-specific etiology, imaging, and treatment, and differential diagnosis. Skeletal Radiol. 46(9):1165-86, 2017
Mandell JC et al: Stress fractures of the foot and ankle, part 1: biomechanics of bone and principles of imaging and treatment. Skeletal Radiol. 46(8):1021-9, 2017
Welck MJ et al: Stress fractures of the foot and ankle. Injury. 48(8):1722-6, 2015
Yu SM et al: MRI of isolated cuboid stress fractures in adults. AJR Am J Roentgenol. 201(6):1325-30, 2013
Brockwell J et al: Stress fractures of the foot and ankle. Sports Med Arthrosc. 17(3):149-59, 2009
Mann JA et al: Evaluation and treatment of navicular stress fractures, including nonunions, revision surgery, and persistent pain after treatment. Foot Ankle Clin. 14(2):187-204, 2009
Burne SG et al: Tarsal navicular stress injury: long-term outcome and clinicoradiological correlation using both computed tomography and magnetic resonance imaging. Am J Sports Med. 33(12):1875-81, 2005
Franco M et al: An uncommon cause of foot pain: the cuboid insufficiency stress fracture. Joint Bone Spine. 72(1):76-8, 2005
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