Bilateral proximal tibial stress fractures

Case contributed by Dr Domenico Nicoletti


Knee pain on both sides after running twenty kilometers without training.

Patient Data

Age: 55
Gender: Male

Subtle horizontally oriented bands of sclerosis at the proximal tibia bilaterally.

Transverse stress fractures of low signal intensity of the proximal tibia bilaterally with surrounding bone marrow edema of high signal.

Case Discussion

Stress fractures are frequently found during competitive sports or intense exercise. They result of a failure of the bone to resist and adapt to stress that is too intense and repetitive. While normally the bone is generally able to adapt to a gradual increase of effort, in some cases this adjustment is insufficient or defective secondary to underlying genetics and/or high-intensity training. 

The sports most affected are running, gymnastics, basketball and aerobics. The regions most affected in runners are the tibia, metatarsal and navicular bones.

Acknowledgements: dott.ssa Eleonora Renzi

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Case information

rID: 35381
Published: 3rd Apr 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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