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Joseph Junewick, MD FACR
over 9 years ago
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Subtrochanteric Stress Fracture

Case Detail

Anatomy: Musculoskeletal
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 9 years ago
Updated: over 9 years ago
Tags: PEDS
Modality/Study Types: MR CR
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Teenage cross country runner with progressive thigh pain.

Case Images


Subtrochanteric Stress Fracture


CR – Vague linear cortical lucency along the proximal medial diaphysis associated with periostitis.

MR – Coronal T1 of the femora, coronal fat-suppressed T2 and inversion recovery, and coronal and axial fat-suppressed gadolinium enhanced T1 images of the femur demonstrate an incomplete linear fracture with moderate marrow and periosteal edema and enhancement.


A stress fracture is an injury that develops from the result of repeated stressful forces. Stress fractures can be classified as either partial or complete. Athletic injuries account for nearly 10% of all stress fractures with the most common location site being the tibia; between 2.8%-7% of athletic related stress fractures occur in the femur. The femur is able to withstand compression forces medially and tension forces laterally but the middle third of the femur to be the most vulnerable to repeated stress. Two specific groups are more disposed to experiencing femur fractures: athletes and military recruits. Military recruits usually are more at risk for distal femur fractures while athletes are more prone to proximal femur fractures. Femur stress fractures are difficult to diagnose, complex to treat, and have a high rate of reoccurrence. Most importantly, early diagnosis results in shorter recovery. The treatment is stress protection (rest and restricted weight-bearing).


Ivkovic A, Bojanic I, Pecina, M. Stress fractures of the femoral shaft in athletes: a new treatment algorithm. Br J Sports Med 2006;40:518–520.


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