Significance of radiographic abnormalities in patients with tibial stress injuries: correlation with magnetic resonance imaging.
OBJECTIVE
The objective was to correlate radiographic findings with magnetic resonance imaging (MRI) findings in patients with suspected tibial stress injuries in order to determine the significance of radiographic signs of stress injury in these individuals.


METHODS
The study group consisted of 80 patients with suspected tibial stress injuries who underwent a radiographic and MR examination of the tibia. Nineteen patients had bilateral involvement. Thus, a total of 99 tibias were evaluated. All radiographs and MR examinations were retrospectively reviewed, 1 month apart, in consensus by two musculoskeletal radiologists. The radiographs were reviewed without knowledge of the site of the clinical symptoms. Fisher's exact tests were used to determine the association between a positive radiograph and the presence of various MRI signs of a high-grade stress injury.


RESULTS
There was a strong association between the presence of periosteal reaction on radiographs at the site of the clinical symptoms and a Fredericson grade 4 stress injury on MRI.


CONCLUSIONS
The presence of periosteal reaction on radiographs at the site of clinical symptoms is predictive of a high-grade stress injury by MRI criteria.
Kijowski
Richard
R
Department of Radiology, University of Wisconsin Hospital, Clinical Science Center-E3/311, 600 Highland Avenue, Madison, WI 53792-3252, USA. r.kijowski@hosp.wisc.edu
Choi
James
J
Mukharjee
Rajat
R
de Smet
Arthur
A
D000293:Adolescent; D000328:Adult; D005260:Female; D015775:Fractures, Stress / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015588:Observer Variation; D016017:Odds Ratio; D011859:Radiography; D012189:Retrospective Studies; D013977:Tibia / Q000000981:diagnostic imaging* / Q000293:injuries / Q000473:pathology*; D013978:Tibial Fractures / Q000175:diagnosis*