Stress fractures.

Anderson, Mark; Greenspan, Adam

doi:10.1148/radiology.199.1.8633129

Cited by 265 publications

(176 citation statements)

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“…Because many other pathological conditions may clinically mimic bone stress injuries, imaging studies are necessary to confirm the diagnosis (13)(14)(15)(16)(17). Radiography is generally used as the primary imaging tool, but its sensitivity in the early stages of these injuries may be as low as 10% (18).…”

Section: Introductionmentioning

confidence: 99%

Can Elevated Serum Tracp-5B Levels Predict Stress Fractures? A Cohort Study

et al. 2009

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Background and Aims: stress fracture is acommonoveruse injury in athletes and military conscripts. the reliable diagnosis of stress fractures is often difficult, however,because it is usually based solely on radiographic findings. biochemical markers of bone resorption reflect bone degradation and may also reflect the rate of bone loss. the aim of the study was to examine whether elevated serum tartrate-resistant acid phosphatase isoform 5b (traCP-5b) levels reflect enhanced bone remodeling and predict the occurrence of stress fractures in military conscripts.Material and Methods: randomly selected military conscripts [mean age, 19.8 (range 18-28) years; n=820] were followed for 3months. baseline blood samples were drawn upon arrival to the service. four subsequent samples were obtained from subjects that developed stress fractures and one sample each was obtained from two asymptomatic control subjects for each fracture case.Results: Plain radiography was used to diagnose stress fractures in 20 of the 820 conscripts (2.4%). follow-up data were available for 14 subjects with 21 stress fractures and 28 control subjects. subjects with proportionally increasing serum traCP-5b levels had an 8-fold greater probability of stress fracture than controls. no statistically significant difference was detected.Conclusions: although assessing serum traCP-5b levels appears to be ap romising method to predict bone stress injuries, the presentstudy failed to give a conclusive statement of its usefulness as adiagnostic tool.

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Section: Introductionmentioning

confidence: 99%

Can Elevated Serum Tracp-5B Levels Predict Stress Fractures? A Cohort Study

et al. 2009

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“…We observed similar findings because, regardless of the strong suspicion by the experienced orthopaedic surgeon, there were no specific findings in the clinical examination on which a bone stress injury diagnosis could have been based. Therefore, imaging studies are always needed to confirm or rule out diagnosis of an injury [3].…”

Section: Discussionmentioning

confidence: 99%

Bone Stress Injuries Are Common in Female Military Trainees: A Preliminary Study

Niva¹,

Mattila

Kiuru³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Although bone stress injuries are common in male military trainees, it is not known how common they are in female trainees. It also is unclear whether asymptomatic bone stress injuries heal if intensive training is continued. We prospectively followed 10 female trainees of a military Reserve Officer Course. The subjects underwent clinical and MRI examinations of the pelvis, thighs, and lower legs at the beginning, once during, and at the end of their 3-month course. We identified two to five injuries in every female trainee, all of whom already had the injuries at the beginning of the officer course. None of these injuries increased their severity despite vigorous training. Two-thirds were asymptomatic and low grade. Femoral and tibial shafts were the most common locations. Higher-grade injuries were more likely symptomatic, but regardless of the MRI findings, female trainees expressed only mild to moderate symptoms. Asymptomatic, low-grade bone stress injuries of the femoral and tibial shaft are common in female recruits undergoing heavy physical training. Because these injuries seem to remain constant or even disappear despite continued heavy physical activity, we do not recommend routine screening of asymptomatic trainees. As some bone stress fractures may have severe consequences (eg, in the femoral neck), symptomatic bone stress injuries should be examined and treated.

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“…A total of 72 subjects were available for this follow-up. The diagnosis of stress fracture was originally based on accepted radiographic, scintigraphic, or MRI criteria [22,23]. The control group, collected also in the early 2000s, consisted of 120 Finnish conscripts who had not had stress fractures before or during military service, based on their military medical records and a questionnaire.…”

Section: Methodsmentioning

confidence: 99%

Genetic predisposition for femoral neck stress fractures in military conscripts

et al. 2010

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BackgroundStress fractures are a significant problem among athletes and soldiers and may result in devastating complications or even permanent handicap. Genetic factors may increase the risk, but no major susceptibility genes have been identified. The purpose of this study was to search for possible genetic factors predisposing military conscripts to femoral neck stress fractures.ResultsEight genes involved in bone metabolism or pathology (COL1A1, COL1A2, OPG, ESR1, VDR, CTR, LRP5, IL-6) were examined in 72 military conscripts with a femoral neck stress fracture and 120 controls. The risk of femoral neck stress fracture was significantly higher in subjects with low weight and body mass index (BMI). An interaction between the CTR (rs1801197) minor allele C and the VDR C-A haplotype was observed, and subjects lacking the C allele in CTR and/or the C-A haplotype in VDR had a 3-fold higher risk of stress fracture than subjects carrying both (OR = 3.22, 95% CI 1.38-7.49, p = 0.007). In addition, the LRP5 haplotype A-G-G-C alone and in combination with the VDR haplotype C-A was associated with stress fractures through reduced body weight and BMI.ConclusionsOur findings suggest that genetic factors play a role in the development of stress fractures in individuals subjected to heavy exercise and mechanical loading. The present results can be applied to the design of future studies that will further elucidate the genetics of stress fractures.

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Stress fractures.

Cited by 265 publications

References 0 publications

Can Elevated Serum Tracp-5B Levels Predict Stress Fractures? A Cohort Study

Can Elevated Serum Tracp-5B Levels Predict Stress Fractures? A Cohort Study

Bone Stress Injuries Are Common in Female Military Trainees: A Preliminary Study

Genetic predisposition for femoral neck stress fractures in military conscripts

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