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Joseph Junewick, MD FACR
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Femoral Stress Fracture

Case Detail

Anatomy: Musculoskeletal
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 10 years ago
Updated: over 9 years ago
Tags: PEDS
Modality/Study Types: MR
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Teenage athlete with unresolving knee pain.

Case Images


Femoral Stress Fracture


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


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.


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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