Stress fractures occur due to repeated stress at the same location, leading to bone fractures. While these fractures are more common in weak bones, they can also develop in strong bones, particularly in athletes and military recruits.
Stress Factures: Symptoms and Diagnosis
Patients typically present with pain and swelling in the affected region, especially during weight-bearing activities. The pain is often progressive, worsening over time. Such injuries are common alongside bones which are already stressed due to osteoporotic changes. However, stress fractures may also form on otherwise robust and healthy bones, especially among individuals who are physically overexerted, such as athletes and military recruits.
X-ray imaging is generally the first-line investigation for diagnosing stress fractures. However, in some cases, an MRI may be required for a more detailed assessment. Interestingly, in the early MRI grading of stress fractures, the initial stages may not show any cortical break (fracture).
Be it surgery that has risen its challenges in accurately diagnosing - critical stress fractures are easier to miss, even ones that have risen their own hurdles and pain and activity limitation is often their primary pain point to those in need of swift resolution to enable movement.
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Importance of Early Detection
It is crucial not to overlook initial symptoms, even if an X-ray appears normal. A high level of suspicion should be maintained, particularly in elderly individuals, athletes, and military personnel. Early diagnosis and treatment can lead to complete symptom resolution. However, if the diagnosis is delayed and a full fracture develops, bone healing takes longer, prolonging symptoms and delaying an athlete’s return to peak performance.
Treatment Approach
Management of stress fractures typically involves rest, bracing, crutches, and bone-stimulating medications to promote healing.
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This article is authored byDr. Sushanth B Mummigatti, Consultant - Orthopaedic & Trauma Surgeon, Manipal Hospital Goa
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