Magnetic resonance imaging findings in patients with fibular stress injuries.
OBJECTIVE
The objective was to evaluate magnetic resonance imaging (MRI) findings in patients with fibular stress injuries.


METHODS
The study group consisted of 20 patients with clinically diagnosed fibular stress injuries who were evaluated with MRI. Radiographs were performed in 14 of the 20 patients. The MRI examinations and radiographs were retrospectively reviewed in consensus by two musculoskeletal radiologists.


RESULTS
All 20 patients with clinically diagnosed fibular stress injuries had periosteal edema and bone marrow edema within the fibula on MRI. The periosteal reaction and bone marrow edema were present within the distal fibula in 14 patients, the middle fibula in 1 patient, and the proximal fibula in 5 patients. The periosteal reaction was located on the anterior cortex in 1 patient, the posterior cortex in 4 patients, the lateral cortex in 11 patients, and circumferentially distributed throughout the cortex in 4 patients. Nine patients had abnormal T1 and T2 signal intensity within the fibular cortex. Initial and follow-up radiographs showed periosteal reaction in 15% and 50% of patients with fibular stress injuries respectively.


CONCLUSIONS
The majority of fibular stress injuries involve the lateral cortex of the distal fibula.
Department of Radiology, University of Wisconsin, Clinical Science Center-E3/311, 600 Highland Avenue, Madison, WI 53792-3252, USA. mwoods@uwhealth.org
Michael
M
Woods
Richard
R
Kijowski
Matthew
M
Sanford
James
J
Choi
Arthur
A
De Smet
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001853:Bone Marrow / Q000473:pathology; D004487:Edema / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D005360:Fibula / Q000293:injuries*; D015775:Fractures, Stress / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies