Saifuddin A, Chalmers A G, Butt W P
St James's University Hospital, Leeds.
Clin Radiol. 1994 Jul;49(7):490-5. doi: 10.1016/s0009-9260(05)81749-0.
Longitudinal stress fractures of the tibia are a recognized but unusual finding in long distance runners. Two cases are presented in which the diagnosis on plain films and scintigraphy (in one case) was not evident. Both patients were referred for MRI. Coronal short tau inversion recovery (STIR) sequences demonstrated extensive hyperintense longitudinal intramedullary signal changes in the tibia. T1-weighted spin-echo scans showed corresponding but less extensive regions of reduced signal intensity. In one case, enhancement of this area was seen following i.v. dimeglumine-gadopentetate (Gd-DTPA). Adjacent soft-tissue abnormality and periosteal reaction was seen in one case but in neither patient was a fracture line identified. Thin section CT with sagittal reformats demonstrated an irregular intracortical longitudinal lucent fracture line which was distinct from the nutrient foramen, establishing the diagnosis.
胫骨纵向应力性骨折在长跑运动员中是一种已被认识但并不常见的发现。本文介绍了两例病例，其中平片和骨闪烁显像（一例）上的诊断并不明确。两名患者均被转诊进行磁共振成像（MRI）检查。冠状位短tau反转恢复（STIR）序列显示胫骨内髓质纵向信号广泛高强化改变。T1加权自旋回波扫描显示相应区域信号强度降低，但范围较小。在一例病例中，静脉注射钆喷酸葡胺（Gd-DTPA）后该区域出现强化。一例病例可见相邻软组织异常和骨膜反应，但两名患者均未发现骨折线。矢状位重建的薄层CT显示一条不规则的皮质内纵向透亮骨折线，与滋养孔不同，从而确立了诊断。
