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Joseph Junewick, MD FACR
over 3 years ago
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Femoral Stress Fracture

Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 4 years ago
Updated: over 4 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

Teenage athlete with unresolving knee pain.


Case Images


Diagnosis

Femoral Stress Fracture

Findings

MR – Linear hypointensity incompletely traverses the medial distal femur. Note the moderate adjacent marrow edema and periostitis.

Discussion

Stress injuries involving the femoral diaphysis are less frequent than those involving the femoral neck or tibia. They occur with a substantial prevalence in middle and long-distance runners. Commonly these fractures occur along the medial aspect of the shaft; this predilection may related to the biomechanical forces exerted on the bone during weight bearing (the medial aspect of the femoral shaft is under compression and the lateral aspect is under tension). The degree of medial compression force increases with contraction of the vastus medialis and adductor longus and brevis muscles.

Reference

Hwang B, Fredericson M, Chung CB et al. MRI Findings of Femoral Diaphyseal Stress Injuries in Athletes. AJR (2005);185:166-173.



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