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Stress Fracture XRay

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1. Stress Fracture XRay

Stress Fracture XRay Stress Fracture XRay Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Stress Fracture XRay Stress Fracture XRay (...) Aka: Stress Fracture XRay II. Epidemiology: Test Sensitivity Early exams: 15% After 3 weeks: 30-70% III. Advantages Low cost Universal availability Low radiation exposure IV. Disadvantages Poor initial V. Signs Faint intracortical radiolucent striations Endosteal or periosteal thickening or sclerosis True line (" ") Cancellous bone Difficult to detect Subtle blurring of landmarks Trabecular margins Sclerotic bands VI. Course Weeks to months to reveal bone remodeling Images: Related links

2018 FP Notebook

2. Comparison of Ultrasound and X-ray as Screening Tests for Diagnosis of Lower Extremity Stress Fracture.

patients will undergo traditional xray screening as well as experimental screening with diagnostic ultrasound. All subjects will undergo confirmatory MRI. Diagnostic Test: Diagnostic Ultrasound The physician performing the ultrasound will be blinded to the results of the x-ray and MRI. The physician performing the ultrasound will be informed of the bone in question (ex. Tibia) and will be able to perform a focused history and exam. The bone in which acute stress fracture is suspected (...) Comparison of Ultrasound and X-ray as Screening Tests for Diagnosis of Lower Extremity Stress Fracture. Comparison of Ultrasound and X-ray as Screening Tests for Diagnosis of Lower Extremity Stress Fracture. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100

2017 Clinical Trials

3. Stress Fracture XRay

Stress Fracture XRay Stress Fracture XRay Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Stress Fracture XRay Stress Fracture XRay (...) Aka: Stress Fracture XRay II. Epidemiology: Test Sensitivity Early exams: 15% After 3 weeks: 30-70% III. Advantages Low cost Universal availability Low radiation exposure IV. Disadvantages Poor initial V. Signs Faint intracortical radiolucent striations Endosteal or periosteal thickening or sclerosis True line (" ") Cancellous bone Difficult to detect Subtle blurring of landmarks Trabecular margins Sclerotic bands VI. Course Weeks to months to reveal bone remodeling Images: Related links

2015 FP Notebook

4. Femoral Neck Stress Fracture

Femoral Neck Stress Fracture Aka: Femoral Neck Stress Fracture From Related Chapters II. Symptoms: Groin Pain or anterior thigh pain Provoked by activity (weight bearing) Relieved with rest III. Signs Pain on internal hip rotation IV. Imaging XRay changes lag symptoms by 2-4 weeks MRI preferred over nuclear bone scan High (similar to bone scan) High (better than bone scan) V. Management Risk Modification See Image the opposite hip if is found (bilateral s are common) Inferior Femoral Neck Stress (...) Femoral Neck Stress Fracture Femoral Neck Stress Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Femoral Neck Stress Fracture

2018 FP Notebook

5. Stress Fracture MRI

: Stress Fracture MRI II. Indication Suspected despite negative serial XRay New gold standard for imaging (supplanting bone scan) III. Epidemiology: Efficacy : High (at least as good as bone scan) : High (better than bone scan) IV. Advantages Highest efficacy of any imaging modality Best detail for differentiating s from other causes No radiation exposure V. Disadvantages Higher cost than other imaging VI. References Images: Related links to external sites (from Bing) These images are a random sampling (...) Stress Fracture MRI Stress Fracture MRI Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Stress Fracture MRI Stress Fracture MRI Aka

2018 FP Notebook

6. Stress Fracture Bone Scan

Fracture Bone Scan Aka: Stress Fracture Bone Scan II. Indication suspected III. Advantages Low cost High IV. Disadvantages More radiation exposure than XRay False postiives with , bone growths V. Epidemiology Sensitivity: 100% False negative case reports exist : Poor VI. Course Bone scan remains abnormal months after healing VII. References Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Stress Fracture Bone Scan." Click (...) Stress Fracture Bone Scan Stress Fracture Bone Scan Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Stress Fracture Bone Scan Stress

2018 FP Notebook

7. Stress Fracture

symptomatic site Vibrating tuning fork (128 Hz) at suspected site Mediocre and Specific Tests for leg or pelvis Stress Fracture Poor (common finding in ) VIII. Differential Diagnosis Primary benign oma Infections Chronic or Chronic Musculoskeletal Metastatic Neoplasm to bone Primary Malignant s Nerve Compression Syndromes Syndrome ted Intervertebral Disc Hypertrophic Pulmonary IX. Imaging Overall imaging approach (preferred) Step 1: XRay negative and Stress Fracture suspicion persists Step 2: Repeat XRay (...) Stress Fracture Stress Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Stress Fracture Stress Fracture Aka: Stress Fracture

2018 FP Notebook

8. Tarsal Navicular Stress Fracture

Tarsal Navicular Stress Fracture Tarsal Navicular Stress Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Tarsal Navicular (...) Stress Fracture Tarsal Navicular Stress Fracture Aka: Tarsal Navicular Stress Fracture From Related Chapters II. Epidemiology Accounts for 14-35% of s Track athletes account for 59% of these injuries III. Mechanism of injury Central one third of navicular is avascular Chronic from repetitive foot strike IV. Risk factors No risk factors identified Most common in track and field athletes Also seen in Australian football and basketball V. Symptoms Cramping pain or ache at the dorsal midfoot Radiates

2018 FP Notebook

9. Metatarsal Stress Fracture

Metatarsal Stress Fracture Metatarsal Stress Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Metatarsal Stress Fracture (...) Metatarsal Stress Fracture Aka: Metatarsal Stress Fracture , March Fracture From Related Chapters II. Epidemiology Second and Third s most commonly involved Military recruits (March Fracture) Ballet Dancers (associated with dance on toe tips) Fifth Metatarsal Stress Fractures are least common Associated with Differentiate from Increased risk of nonunion III. Symptoms Localized pain at site Initially pain onset only with activity IV. Signs Head Axial loading test positive (see ) Point tenderness over site

2018 FP Notebook

10. Calcaneus Stress Fracture

Calcaneus Stress Fracture Calcaneus Stress Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Calcaneus Stress Fracture (...) Calcaneus Stress Fracture Aka: Calcaneus Stress Fracture , Calcaneal Stress Fracture From Related Chapters II. Epidemiology Second most common foot (behind ) III. Pathophysiology Repetitive heel overload Most commonly occurs posterior to the posterior facet of subtalar joint IV. Risk Factors Beginning runner Runners on concrete surface Ballet dancers Increases in weight bearing on hard surfaces V. Symptoms Sudden onset of pain at base of foot Initially pain only with activity ultimately progresses

2018 FP Notebook

11. Tibia Stress Fracture

Tibia Stress Fracture Tibia Stress Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Tibia Stress Fracture Tibia Stress (...) Fracture Aka: Tibia Stress Fracture , Tibial Stress Fracture , Dreaded Black Line From Related Chapters II. Epidemiology Most common Accounts for >50% of s Common overuse injury in runners and jumpers Mid-tibial shaft s Occur in dancers Occur in jumping athletes III. Risk Factors IV. Differential Diagnosis V. Symptoms and signs suggestive of Tibial Stress Fracture Nocturnal pain Extremely painful focal area of tibia Provocative maneuvers Pain on application of vibrating tuning fork Pain elicited

2018 FP Notebook

12. Stress fracture of femoral neck-MRI

play a role. Xray may not demonstrate. If symmetrical, bilateral incomplete fractures seen , osteomalacia is the first possibility Stress fractures are of two varieties (a) superior surface involvement called tension fractures can and do progress and displace (b) Inferior surface fracture called compression variety is stable and shows callus on all modalities usually MRI is good modality to show linear fracture line and marrow edema on either side . Bone scan is also diagnostic like other locations (...) Stress fracture of femoral neck-MRI Stress fracture of femoral neck-MRI - Sumer's Radiology Blog Top Ad unit 728 × 90 Radiology News radiology Stress fracture of femoral neck-MRI Stress fracture of femoral neck-MRI Teaching points by Dr MGK Murthy, MRI technologist: Mr Afroz Stress fractures of femoral neck are uncommon and usually unilateral and seen in military recruits and athletes with unusual physical activity demands. Women more often involved and in post menopausal women,osteoporosis may

2015 Sumer's Radiology Blog

13. Fracture Fridays: Can’t put a finger on it (Re-post)

Fracture Fridays: Can’t put a finger on it (Re-post) Fracture Fridays: Can’t put a finger on it (Re-post) – PEMBlog Search for: Search for: Fracture Fridays: Can’t put a finger on it (Re-post) The Case An athlete presents to the ED with an injured pinky finger. He says that he struck it on a teammate during practice and “it bent back.” The pinky finger is abducted and jutting out at an extreme angle. It is making dad nauseous. The XRay shows the following: Diagnosis This is a Salter-Harris II (...) fracture of the proximal 5th phalanx. The physis is stressed during impact and it is fractured because of the pull of the collateral ligament. You will often see an abducted, angulated digit. This is the most common proximal finger fracture in children. When it occurs in the 5th digit as seen in this example it is known as an extra-octave fracture . The term alludes to abducting the pinky finger to try to reach piano keys that are too far away. The initial degree of angulation can be severe, often 60

2018 PEM Blog

14. Fifth Metatarsal Fracture

) Anticipate healed with union on XRay by 8 weeks VIII. Management: Diaphyseal Fractures (Jones Fracture or Diaphyseal Stress Fractures) Indications for orthopedic referral See Fifth Metatarsal Fracture for absolute referral indications Consider in all patients given higher risk of non-union Athletes may also benefit from referral by decreasing duration of healing time Displacement >2mm Inadequate healing after immobilization for 12 weeks Non-union on xray Initial management Posterior splint Non-weight (...) and pivoting in young athletes ( ) Insidious pain onset with activity Highest risk area for non-healing s IV. Symptoms Distribution: Lateral Provocative: Walking Timing: Acute s: Sudden onset s: Gradually progressive and increased with activity V. Signs Localized swelling and at the base of the fifth VI. Imaging: XRay demonstrates Proximal Fifth Metatarsal Fracture See See Types above for determining type Differential diagnosis on XRay of Proximal Fifth Metatarsal Fracture look-alikes Accessory bones

2018 FP Notebook

15. Fracture

are typically safe for short-term use unless other contraindications (e.g. renal disease, peptic ulcer) Theoretical risk of delayed Fracture healing, but variable findings in human studies does not appear to significantly delay Fracture healing See s for details (2017) Presc Lett 24(2): 9 Follow-up Re-evaluation in 5-7 days (sooner for s) Repeat XRay and at time of follow-up Patient precautions for immediate return Numb, cold, pale, immobile distal extremity Increasing pain out of proportion to what would (...) because of car accidents, or . Other causes are and , which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone. Symptoms of a fracture are Out-of-place or misshapen limb or joint Swelling, bruising or bleeding Intense pain Numbness and tingling Limited mobility or inability to move a limb You need to get medical care right away for any fracture. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws

2018 FP Notebook

16. Vertebral Compression Fracture

Vertebral Compression Fracture Vertebral Compression Fracture Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Vertebral Compression (...) Fracture Vertebral Compression Fracture Aka: Vertebral Compression Fracture , Vertebral Crush Fracture From Related Chapters II. Causes Most common complication (700,000 related U.S. l s per year) Cancer with lytic bony metastases III. Risk Factors See Prior l confers 5 fold increased risk Chronic use of s (>5 mg daily for 3 months) Increasing age over 50 years old Weihgt <117 lb (<53 kg) Female gender Heavy use (>2/day in women, >3/day in men) abuse IV. Symptoms Sudden onset of severe back pain

2018 FP Notebook

17. Ankle Fracture

Swelling Inability to bear weight Significant deformity if dislocation present VI. Associated Conditions Maisonneuve ( , rotational injury) Associated with Lateral CT ankle indicated for significant swelling at lateral talus despite negative xray VII. Imaging See (consider xrays of foot and tibia-fibula) Instability findings Widening of ankle mortise (Weber C and some Weber B Fractures) Consistent with unstable Ankle Fracture Lateral talus displacement on gravity stress or external rotation (Weber B (...) Trimalleolar Fracture Maisonneuve Weber B Fracture with instability (refer all Weber B Fractures to orthopedics for reevaluation) Findings suggestive of instability mortise wide Lateral talus displacement on gravity stress or external rotation Findings suggestive of stability (stable in 98% of cases if both criteria present) Posterior displacement of of distal fragment <2mm (on lateral XRay) Only two fragments Initial management Immobilize in fiberglass or plaster splint (sugar tong with or without

2018 FP Notebook

18. Talus Fracture

, Snowboarder's Fracture , Lateral Process Talar Fracture , Talar Stress Fracture II. Mechanism Acute (rare in sports) High energy foot injury Severe foot dislocations (associated with talar neck ) Snowboarder's Fracture Lateral process Talus Fracture Often misdiagnosed as Occurs with acute dorsiflexion and foot inversion under axial load (rare) III. Imaging Initial imaging XRay CT Imaging Indications High index of suspicion for Talus Fracture despite negative XRay IV. Complications Subtalar Dislocation (...) Avascular Necrosis V. Management Talar body s Non-displaced talar body s are treated with non-weight bearing and or boot Displaced talar body s are often surgically managed Talar neck s Emergent orthopedic if displaced talar neck Lateral Process Talar Fracture (Snowboarder's Fracture) Non-displaced Non-weight bearing in boot or cast for 6 weeks Displaced Surgery (typically ORIF) Talar Stress Fracture Relative rest, support shoe, walking boot (CAM Boot), or non-weight bearing Resolution may require up

2018 FP Notebook

19. Stress Fracture MRI

: Stress Fracture MRI II. Indication Suspected despite negative serial XRay New gold standard for imaging (supplanting bone scan) III. Epidemiology: Efficacy : High (at least as good as bone scan) : High (better than bone scan) IV. Advantages Highest efficacy of any imaging modality Best detail for differentiating s from other causes No radiation exposure V. Disadvantages Higher cost than other imaging VI. References Images: Related links to external sites (from Bing) These images are a random sampling (...) Stress Fracture MRI Stress Fracture MRI Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Stress Fracture MRI Stress Fracture MRI Aka

2015 FP Notebook

20. Stress Fracture Bone Scan

Fracture Bone Scan Aka: Stress Fracture Bone Scan II. Indication suspected III. Advantages Low cost High IV. Disadvantages More radiation exposure than XRay False postiives with , bone growths V. Epidemiology Sensitivity: 100% False negative case reports exist : Poor VI. Course Bone scan remains abnormal months after healing VII. References Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Stress Fracture Bone Scan." Click (...) Stress Fracture Bone Scan Stress Fracture Bone Scan Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Stress Fracture Bone Scan Stress

2015 FP Notebook

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