Stress Fractures in Skeletally Immature Patients

Stress Fractures of the Femoral Diaphysis in Children

“…In patient 4, a fibrous cortical defect at the site of the stress fracture weakened the bone, making it susceptible to failure, and this can be a risk factor. Similar cases were reported by Meany and Carty 7 and also by Walker et al 10 The identification of a periosteal reaction was usually possible on the initial radiograph, as in four of our five patients. The healing reaction occurs at an increased rate in children, so it is not common to obtain a radiograph prior to the onset of a periosteal reaction.…”

“…To our knowledge, less than a dozen cases have been reported in the English literature. [3][4][5][6][7][8][9][10] In one study on 40 stress fractures in children, there was not a single stress fracture of the femoral diaphysis. 11 Subsequent to the report by Burks and Sutherland in 1984, 4 more cases are being reported.…”

“…Apparently, the exaggerated activities that young children display with normal life provide enough stress to skeletal tissue to elicit a stress fracture. [1][2][3][4]10 Because a child's history may be nebulous about recent trauma, undisplaced occult fractures or greenstick fractures may go unrecognized due to the increased elasticity of young bone. Because the clinical presentation and imposing problems of occult fractures are similar to stress fractures, the differentiation of these two injuries is only of academic interest.…”

Androgen Receptor CAG Repeat Size is Associated with Stress Fracture Risk: A Pilot Study

“…Of the other studies focusing primarily on older men, most reported no association between AR CAG repeat length and BMD [16,28,33,35]. Two studies focusing on younger individuals also did not show any consistent association between BMD and CAG repeat, although the numbers were limited [34,39]. Recently Guadalupe-Grau et al [14] analyzed the association between the AR CAG repeats and bone density in 282 healthy Spanish men (mean age, 28.6 ± 7.6 years) and reported that no associations between CAG repeat length and regional bone mineral content or BMD were observed after adjusting for age.…”

The Knee: MR Imaging of Uniquely Pediatric Disorders

“…In skeletally immature patients, the tibia is the most common site (at the proximal posteromedial metadiaphyseal junction), followed by the fibula (21%) and femur (12%). 25 These fractures usually occur in teenagers. Stress fractures have also been reported in teenage female athletes with osteoporosis, amenorrhea, and eating disorders, the so-called ''female athlete triad.''…”