Roth Sandor, Sestan Branko, Tudor Anton, Dapić Tomislav, Cicvarić Tedi, Miletić Damir
Clinical Hospital Center Rijeka, Rijeka Croatia, Croatia.
J Pediatr Orthop B. 2008 Jul;17(4):195-8. doi: 10.1097/BPB.0b013e328304612e.
This report is a unique case of three stress fractures in a 14-year-old active female basketball player and we emphasize the importance of triple-phase bone scanning in differential diagnosis of the stress fracture. According to radiographic examination and laboratory tests, which were normal, the stress fracture of the right fibula was strongly suspected while making the diagnosis. Despite the treatment applied, recurrence, and deterioration of the symptoms were presented. Repeated laboratory test results were again normal, but the presence of an abundant periosteal reaction on the plain radiographs was confusing, so osteomyelitis or Ewing sarcoma of the fibula was suspected. We decided to perform a three-phase bone scanning; its findings were critical for the judgment and we diagnosed three stress fractures involving both fibulae. Final confirmation of the diagnosis of the bilateral fibular stress fractures in our case, however, was done by computed tomography examination.
本报告是一名14岁活跃的女性篮球运动员发生三处应力性骨折的独特病例，我们强调三相骨扫描在应力性骨折鉴别诊断中的重要性。根据正常的影像学检查和实验室检查结果，在诊断时强烈怀疑右腓骨应力性骨折。尽管进行了治疗，但仍出现症状复发和恶化。重复的实验室检查结果再次正常，但平片上大量骨膜反应的出现令人困惑，因此怀疑为腓骨骨髓炎或尤因肉瘤。我们决定进行三相骨扫描；其结果对判断至关重要，我们诊断出双侧腓骨均有三处应力性骨折。然而，在我们的病例中，双侧腓骨应力性骨折诊断的最终确认是通过计算机断层扫描检查完成的。
