Presentation
Left lower extremity pain
Patient Data
Frontal and lateral radiograph of the tibia shows changes from Paget disease with an additional transverse sclerotic line through the anterior cortex, compatible with a characteristic insufficiency fracture known as a "banana fracture."
Bowing of the tibia anteriorly, beginning to assume the curved shape of a banana.
(The technologist placed the radiopaque arrow to point to the patient's region of pain)
Case Discussion
The softening of bone that occurs in Paget disease makes it susceptible to insufficiency fracture.
A "banana fracture" is one of these insufficiency fractures. One can tell it is an insufficiency fracture and not a fatigue stress fracture because a) it occurs in a region of abnormal bone and more importantly, b) the fracture occurs in an area of tensile stress, not compressive stress.
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