The accurate diagnosis of stress-induced changes in the foot and ankle requires careful and detailed clinical history and examination. This is of paramount importance in ensuring the correct imaging interpretation and for excluding other differential diagnoses. Advanced imaging (scintigraphy and MR imaging) plays a vital role in the early diagnosis of this type of injury, and CT has an important contributory role in the diagnosis of injury where imaging features by the other modalities are equivocal. An early diagnosis reached by judicious use of imaging techniques is the cornerstone of appropriate management, with a high probability of a full recovery, a low risk of complications, and a return to pre-disease activity.