Stress Reactions in Bone and Stress Fractures

Area of Science:

• Orthopedics
• Radiology
• Biomedical Engineering

Background:

• Stress fractures are bone injuries from repetitive loading beyond repair capacity.
• Classified as fatigue fractures (abnormal stress on healthy bone) or insufficiency fractures (normal stress on weakened bone).

Purpose of the Study:

• To review the pathophysiology and clinical classifications of stress-related skeletal injuries.
• To discuss specific manifestations and predisposing biomechanical factors.
• To overview emerging imaging technologies for early detection and prevention.

Main Methods:

• Literature review of stress fracture pathophysiology, classification, and manifestations.
• Discussion of biomechanical factors contributing to stress injuries.
• Overview of advanced imaging techniques like zero echo time MRI and deep learning-based synthetic CT.

Main Results:

• Distinguishes between fatigue and insufficiency fractures.
• Highlights specific conditions like spondylolysis, distal clavicular osteolysis, atypical femur fractures, and pregnancy-associated vertebral fractures.
• Introduces novel deep learning applications for osteoporosis screening and fracture prevention.

Conclusions:

• Understanding stress fracture mechanisms is crucial for diagnosis and management.
• Emerging technologies offer promising avenues for early detection and preventative strategies.
• Deep learning holds potential for automated screening and reducing catastrophic fractures.