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Scintigraphic findings in stress fractures
The Journal of Bone and Joint Surgery. American Volume
|October 1, 1977
Summary
Bone scintigraphy is more effective than standard X-rays for diagnosing stress fractures. While X-rays missed 71% of stress fractures initially, scintigraphy identified them, though it had a 24% false positive rate.
Area of Science:
- Orthopedics
- Radiology
- Nuclear Medicine
Background:
- Stress fractures are common injuries, particularly in athletes.
- Early diagnosis is crucial for effective management and preventing complications.
- Conventional radiography (X-rays) has limitations in detecting early stress fractures.
Purpose of the Study:
- To compare the diagnostic accuracy of bone scintigraphy and serial roentgenograms for suspected stress fractures.
- To determine the false negative rate of roentgenograms and the false positive rate of scintigraphy.
Main Methods:
- Forty-two patients with suspected stress fractures were evaluated.
- Serial roentgenograms were performed.
- A total-body bone scan with detailed views of suspicious areas was conducted.
Main Results:
- Stress fracture was diagnosed in 21 patients.
- Roentgenograms were normal in 15 of these 21 patients (71% false negative rate).
- Bone scintigraphy was positive in these 15 patients; 11 later showed positive roentgenograms.
- Five positive scintigrams were due to other causes (24% false positive rate).
- Commonly affected bones included metatarsals, calcaneus, tibia, femur, and fibula.
Conclusions:
- Bone scintigraphy is a sensitive imaging modality for diagnosing stress fractures, especially when initial roentgenograms are negative.
- While scintigraphy has a higher false positive rate than radiography, its sensitivity aids in early detection.
- Further investigation may be needed to differentiate true stress fractures from other scintigraphic findings.