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Related Experiment Videos

False negative bone scan in a female runner

J C Sterling1, R F Webb, M C Meyers

  • 1Texas Center for Sports Medicine and Orthopedic Surgery, Sugar Land.

Medicine and Science in Sports and Exercise
|February 1, 1993
PubMed
Summary
This summary is machine-generated.

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Stress fractures of the femoral neck are common in athletes. A high clinical suspicion is crucial for diagnosing these injuries, even when initial imaging, including bone scans, is negative.

Area of Science:

  • Orthopedics
  • Sports Medicine
  • Radiology

Background:

  • Stress fractures, particularly of the femoral neck, are increasingly diagnosed in active individuals.
  • Accurate diagnosis relies on a combination of clinical history, physical examination, and advanced imaging techniques.

Observation:

  • A 42-year-old female marathon runner presented with hip pain suggestive of a femoral neck stress fracture.
  • Initial diagnostic workup, including radiographs and a triple-phase bone scan, yielded negative results.
  • Persistent symptoms led to a repeat X-ray, which revealed a superior femoral neck fracture.

Findings:

  • The triple-phase bone scan, often considered the gold standard for occult stress fractures, produced a false-negative result in this case.
  • Despite the negative bone scan, persistent clinical symptoms prompted further investigation.

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  • A repeat radiograph ultimately confirmed the diagnosis of a femoral neck stress fracture.

    • Implications:

    • This case highlights the importance of maintaining a high clinical index of suspicion for femoral neck stress fractures, even with non-diagnostic ancillary tests.
    • Delayed or missed diagnosis of femoral neck stress fractures can lead to severe complications, such as avascular necrosis of the femoral head.
    • Emphasizes the critical role of clinical judgment in managing potential stress fractures when imaging is inconclusive.