Stress Fracture XRay

Aka: Stress Fracture XRay

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II. Epidemiology: Test Sensitivity

  1. Early exams: 15%
  2. After 3 weeks: 30-70%

III. Advantages

  1. Low cost
  2. Universal availability
  3. Low radiation exposure

IV. Disadvantages

  1. Poor initial Test Sensitivity

V. Signs

  1. Cortical Bone
    1. Faint intracortical radiolucent striations
    2. Endosteal or periosteal thickening or sclerosis
    3. True Fracture line ("Dreaded Black Line")
  2. Cancellous bone
    1. Difficult to detect
    2. Subtle blurring of landmarks
      1. Trabecular margins
      2. Sclerotic bands

VI. Course

  1. Weeks to months to reveal bone remodeling

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