Öz
A male professional basketball player was admitted to our orthopedic department with complaints of severe pain at his left lower leg with duration of one week. There were no apparent acute pathologic findings at cruris X-Ray in standart anteroposterior and lateral projections, except changes related to old fibula diaphyseal fracture. Vertically oriented increased activity was detected with three-phase bone scintigraphy. In computed tomography CT examination, a 9 cm craniokaudal cortical cleft was detected at the anteromedial surface of mid-distal tibial diaphysis. Tibial cortical cleft and concomitant bone marrow edema accompanied by soft tissue changes were detected with magnetic resonance imaging MRI . Tibial longitudinal stress fracture was diagnosed with these findings. The complaints of the patient markedly improved with rest and conservative treatment. He returned to active sports at the end of a month. In this case report, direct X-Ray, CT scan, MRI and scintigraphy findings of tibial longitudinal stress fracture are presented and discussed in the light of similar reports
Anahtar Kelimeler
Kaynakça
- Devas MB Longitudinal stress fractures. Another variety seen in long bones. J Bone Joint Surg Br 1960; 42: 508-514
- Greaney RB, Gerber FH, Laughlin RL, Kmet JP, Metz CD, Kilcheski TS, Rao BR, Silverman ED. Distrubition and natural history of stress fractures in US Marine recruits. Radiology 1983; 146 : 339-346
- McMahon CJ, Shetty SK, Anderson ME, Hochman MG Case repost: Longitudinal stress fracture of the humerus:imaging features and pitfalls. Clin. Orthop Relat Res 2009;467(12):3351-5
- Lee JK, Yao L. Stress fractures: MR imaging. Radiology 1998; 169:217-220
- Meyers SP, Wiener SN. Magnetic resonance imaging features of fractures using the short tau inversion recovery ( STIR) sequence:correlation with radiographic findings. Skeletal Radiol 1991; 20:499-507
- Daunt N, Gribbin D, Slater GS. Longitudinal tibial stress fractures. Australas Radiol 1998; 42: 188-190
- Allen GJ Longitudinal stress fractures of the tibia:diagnosis with CT. Radiology 1988; 167: 799-801
- Miniaci A, McLaren AC, Haddad RG. Longitudinal stress fracture of the tibia: case report. J Can Assoc Radiol 1988; 39:221-223
- Goupille P, Giraudet-Le Quintrec JS, Job-Desclandre C, Menkes CJ. Longitudinal stress fractures of the tibia:diagnosis with CT. Radiology 1989; 171:583
- Anderson MW, Ugalde V, Batt M, Greenspan A . Longitudinal stress fractures of the tibia: MR demonstration. J Comput Assist Tomogr 1996; 20: 836-838
- Keating JF, Beggs I, Thorpe G. Three cases of longitudinal stress fracture of the tibia. Acta Orthop Scand 1995; 66: 41-42
- Saifuddin A, Chalmers AG, Butt WP Longitudinal stress fracture of the tibia: MRI features in two cases. Clin Radiol 1994; 49 : 490-495
- Feydy A, Drape J-L, Beret E, Sarazin L, Pessis E, Minoui A, Chevrot A. Longitudinal stress fractures ot the tibia: comparative study of CT and MR imaging. Eur Radiol. 1998; 8:598-602
- Somer K, Meurman KO Computed tomography of stress fractures. J Comput Assist Tomogr 1982; 6 : 109-115
- Yousem D, Magid D, Fishman EK, Kuhajda F, Siegelman SS Computed tomography of stress fractures. J Comput Assist Tomogr 1986; 10:92-95
Öz
22 yaşında profesyonel basketbol oyuncusu erkek hasta, bir haftadır süregelen eforla oluşan sol bacakta ağrı şikayeti ile ortopedi kliniğine başvurdu. İki yönlü kruris grafisinde eski fibula kırığına bağlı değişiklikler dışında patolojik bulgu izlenmezken üç fazlı kemik sintigrafisinde tibiada vertikal uzanımlı aktivite artışı saptandı. Çok kesitli Bilgisayarlı Tomografi ÇKBT incelemesinde tibia orta-distal diafiz anteromedial yüzde kraniokaudal 9 cm’lik segmentte kortikal kleft saptandı. Magnetik Rezonans Görüntülemede MRG tibiada kortikal klefte eşlik eden kemik iliği ödemi ve yumuşak doku değişiklikleri mevcuttu. Radyolojik bulgular ışığında tibiada longitudinal stres kırığı tanısı konuldu. İstirahat ve medikal tedavi ile hastanın şikayetleri belirgin geriledi ve bir ayın sonunda aktif spor yaşantısına geri döndü. Olgu sunumumuzda literatürde az rastlanan tibia longitudinal stres kırığının direkt grafi, ÇKBT, MRG ve sintigrafi bulguları literatür bulguları eşliğinde tartışılmıştır
Anahtar Kelimeler
Kaynakça
- Devas MB Longitudinal stress fractures. Another variety seen in long bones. J Bone Joint Surg Br 1960; 42: 508-514
- Greaney RB, Gerber FH, Laughlin RL, Kmet JP, Metz CD, Kilcheski TS, Rao BR, Silverman ED. Distrubition and natural history of stress fractures in US Marine recruits. Radiology 1983; 146 : 339-346
- McMahon CJ, Shetty SK, Anderson ME, Hochman MG Case repost: Longitudinal stress fracture of the humerus:imaging features and pitfalls. Clin. Orthop Relat Res 2009;467(12):3351-5
- Lee JK, Yao L. Stress fractures: MR imaging. Radiology 1998; 169:217-220
- Meyers SP, Wiener SN. Magnetic resonance imaging features of fractures using the short tau inversion recovery ( STIR) sequence:correlation with radiographic findings. Skeletal Radiol 1991; 20:499-507
- Daunt N, Gribbin D, Slater GS. Longitudinal tibial stress fractures. Australas Radiol 1998; 42: 188-190
- Allen GJ Longitudinal stress fractures of the tibia:diagnosis with CT. Radiology 1988; 167: 799-801
- Miniaci A, McLaren AC, Haddad RG. Longitudinal stress fracture of the tibia: case report. J Can Assoc Radiol 1988; 39:221-223
- Goupille P, Giraudet-Le Quintrec JS, Job-Desclandre C, Menkes CJ. Longitudinal stress fractures of the tibia:diagnosis with CT. Radiology 1989; 171:583
- Anderson MW, Ugalde V, Batt M, Greenspan A . Longitudinal stress fractures of the tibia: MR demonstration. J Comput Assist Tomogr 1996; 20: 836-838
- Keating JF, Beggs I, Thorpe G. Three cases of longitudinal stress fracture of the tibia. Acta Orthop Scand 1995; 66: 41-42
- Saifuddin A, Chalmers AG, Butt WP Longitudinal stress fracture of the tibia: MRI features in two cases. Clin Radiol 1994; 49 : 490-495
- Feydy A, Drape J-L, Beret E, Sarazin L, Pessis E, Minoui A, Chevrot A. Longitudinal stress fractures ot the tibia: comparative study of CT and MR imaging. Eur Radiol. 1998; 8:598-602
- Somer K, Meurman KO Computed tomography of stress fractures. J Comput Assist Tomogr 1982; 6 : 109-115
- Yousem D, Magid D, Fishman EK, Kuhajda F, Siegelman SS Computed tomography of stress fractures. J Comput Assist Tomogr 1986; 10:92-95
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Case Report |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2012 |
| Yayımlandığı Sayı | Yıl 2012Sayı: 1 |