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C-0922 - Low and high risk stress fractures of the lower limb: multimodal imaging and diagnostic algorithm.

N. How Kit, L. FOURNIER, L. Florescu, J. Pelage; Caen/FR Type: Educational Exhibit
Area of Interests: Bones, Extremities, Musculoskeletal system
Imaging Techniques: SPECT-CT, MR, Conventional radiography
Procedure: Diagnostic procedure
Special Focus: Athletic injuries
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Learning objectives: To illustrate imaging features of stress fractures of the lower limb with conventional radiography, ultrasonography, CT scan, bone scan/SPECT-CT scan and MRI.   To propose a multimodal imaging diagnostic algorithm for an early clinical management.  

Background: Stress fractures result from an imbalance between the strength of the bone and the exerted constraints in the absence of traumatism or preexisting focal lesions. Common in military recruits and athletes, symptoms consist in progressive mechanical pain and stress fractures are often not initially dia[...]

Findings and procedure details: IMAGING OF STRESS FRACTURES         1) Conventional Radiography (CR): (Figure 1)     Conventional radiography should be the first-choice investigation for the accessibility, the cost and for the differential diagnosis (bone tumors). Initial radiographs [...]

Conclusion: A perfect knowledge of the topography and the imaging features of low and high risk stress fractures of the lower limb is required for an optimal imaging evaluation. The diagnostic algorithm may evolve with the improvement of imaging technologies.

Personal information: Nicolas How Kit, MD  Department of Diagnostic Imaging and Interventional Radiology CHU de Caen, Normandie University UNICAEN, France, howkit-n@chu-caen.fr     Luc Fournier, MD Department of Diagnostic Imaging and Interventional Radiology CHU de Caen, Normandie University UNICAEN, Fran[...]

References: 1.   Boden BP, Osbahr DC. High-risk stress fractures: evaluation and treatment. J Am Acad Orthop Surg. 2000;8(6):344-53.       2.   McInnis KC, Ramey LN. High-Risk Stress Fractures: Diagnosis and Management. PM R. 2016;8(3 Suppl):S113-24.       3.&nb[...]

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