Stress fractures: MR imaging

Five cases of stress fracture were studied with high-field-strength magnetic resonance (MR) imaging. In all cases, MR images showed bandlike areas of very low signal intensity in the intramedullary space, which were continuous with the cortex. These findings corresponded in location to the sites of fracture or new bone formation noted on radiographs. Surrounding areas of decreased signal intensity in the marrow space were also consistently seen on T1-weighted images. In three cases, prominent intramedullary areas of high signal intensity were noted on T2-weighted images obtained within 3 weeks of the onset of symptoms. Juxtacortical and/or subperiosteal areas of high signal intensity were also seen on T2-weighted images in two cases. Characteristic MR findings may distinguish stress fracture from occult intraosseous fracture.