Prognostic value of focal scintigraphic findings in clinically suspected cases of tibial stress fracture.

Wagner Castropil,Carlos Alberto Buchpiguel,Amisa Guimarães

doi:10.1590/0100-3984.2017.0028

Abstract

ObjectiveTo investigate the correlation between tracer uptake on bone scintigraphy and recovery time in patients with tibial stress fracture.Materials and MethodsWe evaluated two groups of athletes: those with clinical suspicion and a radiological diagnosis of tibial stress fracture (TSF group, n = 21); and those with no symptoms or evidence of fracture (control group, n = 10). All subjects underwent bone scintigraphy and magnetic resonance imaging with a maximum interval of 7 days between the assessments.ResultsUsing the region of interest technique, we obtained a quantitative evaluation index, comparing affected and unaffected legs. The mean uptake of 99mTc-MDP was significantly higher in the TSF group than in the control group (2.54 ± 0.77 vs. 1.05 ± 0.11; p < 0.001).ConclusionIn our sample of athletes, determining the bone scintigraphy uptake indices provided an objective method to estimate the appropriate recovery time after a tibial stress fracture.

Highlights

In competitive sports, overload injuries are common and may involve the entire locomotor system
In the 1970s and 1980s, when individuals began to increase the frequency and intensity of their exercise regimens, several aspects related to stress fractures were first investigated in the physically active population[3,4]
Bone scintigraphy and magnetic resonance imaging (MRI) have provided valuable information regarding bone anatomy and metabolism in patients with stress fractures, alowing subtle and early abnormalities in the structure of bone under stress to be identified[5,6]. These two methods may be applied to confirm the clinical diagnosis of a stress fracture, because both have extremely high sensitivity in the detection of fractures or bone abnormalities

Summary

Introduction

Overload injuries are common and may involve the entire locomotor system. Bone scintigraphy and magnetic resonance imaging (MRI) have provided valuable information regarding bone anatomy and metabolism in patients with stress fractures, alowing subtle and early abnormalities in the structure of bone under stress to be identified[5,6]. These two methods may be applied to confirm the clinical diagnosis of a stress fracture, because both have extremely high sensitivity in the detection of fractures or bone abnormalities

Methods

Findings

Discussion

Conclusion