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M R I - Division

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X-ray AP View   Magnified Image
CT Scan Axial sections at the level of lesion   CT Scan Axial sections at the level of lesion
MRI coronal sections T1 Wt. image   MRI coronal sections T2 Wt. image



Complaint : 38Y, Non athletic female  Right leg pain from one year.


          X-ray AP View, CT Axial sections, MRI thigh, T1,T2 Wt. images of Coronal sections.


           Two small incomplete transverse fractures (Arrows)  with callus confined to medial cortex in the proximal &mid diaphysis  of the femor,

            bilaterally. No E/o associated edema / soft tissue. Bone density is normal.

DIAGNOSIS:  Stress Fractures in the shaft of the femur, bilaterally.


       Bilateral femoral stress fractures are extremely uncommon, majority  occur in athletes.  Femoral stress fractures  can be divided

       into those involving the femoral neck, condyles or shaft. Those of the femoral shaft are reported to comprise between 2.8 and

       21 percent of femoral stress fractures in athletes. 


       Stress fractures occurred in both femurs, localized to both posteromedial shafts. This area of the femur has been shown to have

       the greatest strain in the sagittal plane, but is also susceptible to stress fracture due to the origin of the vastus medialis and the

       insertion of the adductor brevis.


       In cases of overuse and elevated bone stress, it is suspected that either muscle fatigue leads to a decrease in the ability to absorb

       shock, and /or highly concentrated forces act through small areas of tendinous insertion to overload bone.



       Femoral shaft stress fractures are stable stress fractures that can be treated with a progressive rehabilitation program.


REFERENCE :  http://www.uihealthcare.com/depts/med/orthopaedicsurgery/research/ioj/ioj2005/sports/rarebilateral.pdf

SUBMITTED BY:  Academic division, 'MA' Advanced Diagnostic & Research Centre, Guntur, AP. INDIA.

                              DR. M.ADINARAYANA RAO. MD.

                              DR. G.GOWRI SEKHAR . DNB.,DMRD.

                              DR. D. PRASAD REDDY. DMRD.

                              DR.J.V.NARASIMHA RAO, MS.(ORTHO).



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