Stress fractures

Stress fractures are a major cause of morbidity in the athletic and military population. Long distance running and female sex are major risk factors. Clinicians must have a high index of suspicion as early diagnosis and treatment is crucial. Provocative tests such as one-foot hopping are helpful in diagnosis. MRI (or isotope bone scanning) is much more useful than plain radiography. Treatment is usually by avoidance or modification of the stressful activity, but some fractures may need internal fixation and possibly bone grafting.