title: Significance of radiographic abnormalities in patients with tibial stress injuries: correlation with magnetic resonance imaging.
abstract: 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.
authors: 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
authors: Richard
authors: R
authors: Kijowski
authors: James
authors: J
authors: Choi
authors: Rajat
authors: R
authors: Mukharjee
authors: Arthur
authors: A
authors: de Smet
mesh_terms: 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*