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Bone stress: a radionuclide imaging perspective.

L W Roub, L W Gumerman, E N Hanley

    Radiology
    |August 1, 1979
    PubMed
    Summary
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    Radionuclide imaging can detect bone stress in athletes even when X-rays are negative. This bone scan appearance is characteristic of bone stress, aiding diagnosis in athletes with lower leg pain.

    Area of Science:

    • Orthopedics
    • Sports Medicine
    • Radiology

    Background:

    • Lower leg pain is common in college athletes.
    • Stress fractures are a frequent cause, often diagnosed via radiography and radionuclide studies.
    • Differentiating bone stress from other causes of pain is crucial for timely treatment.

    Purpose of the Study:

    • To evaluate the diagnostic utility of radionuclide imaging (bone scans) in college athletes with lower leg pain.
    • To correlate scintigraphic findings with radiographic results in suspected cases of bone stress.
    • To propose a schema explaining discrepancies between bone scans and X-rays.

    Main Methods:

    • Thirty-five college athletes with lower leg pain were studied.
    • Radiography and radionuclide imaging were performed on symptomatic and asymptomatic extremities.

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  • A control group of 13 pain-free athletes was included.
  • Main Results:

    • Four patterns of findings were observed: positive X-ray/positive bone scan, negative X-ray/positive bone scan, negative X-ray/abnormal bone scan, and negative X-ray/negative bone scan.
    • Patients with sharply marginated scintigraphic abnormalities and positive or negative radiographs were considered to have bone stress.
    • The scintigraphic appearance was deemed characteristic of bone stress irrespective of radiographic findings.

    Conclusions:

    • Radionuclide imaging is a valuable tool for detecting bone stress in athletes, even when radiographs are negative.
    • The study proposes a schema to explain positive bone scans with negative radiographs in bone stress.
    • Early and accurate diagnosis of bone stress is essential for athlete management.