Pediatric Radiology > Musculoskeletal > Trauma > Stress Reactions

Stress Reactions

Stress fractures are injuries caused by repetitive trauma. Stress injuries usually manifest themselves when a new or intense activity is started. Most common locations: tibia > fibula > metatarsals > calcaneus. Radiographic appearances include a) periosteal new bone formation, b) transverse or oblique band of sclerosis, or c) a lucent line surrounded by sclerosis. Often new periosteal bone will be the only finding.

Stress reaction involving the tibia. Lateral radiograph (left) of a 13-year-old boy shows marked cortical thickening and sclerosis surrounding a horizontal lucency through the anterior cortex of the tibia. AP radiograph (right) of a 6-year-old boy demonstrates periosteal reaction (arrow) on the medial aspect of the proximal tibia.

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