Reason: stress fracture at distal metadiaphyseal junction History: pain There is increased bone marrow signal abnormality within the proximal tibial metadiaphysis on fluid sensitive sequences which may represent stress reaction in the correct clinical context (image 8; series 5). No discrete fracture line is identified at this time. There is no disruption of the cortex in the surrounding area. Additionally, there is a smaller focus of increased bone marrow signal abnormality within the distal tibial metadiaphysis which may simply represent residual islands of red marrow although minimal stress reaction could also be considered correct clinical context (image 13; series 5). There is slight increased signal abnormality on fluid sensitive sequences within the medial and lateral heads of the gastrocnemius muscle which may represent a mild muscle strain but this is nonspecific. The remainder of the imaged musculature of the right leg is unremarkable. On the large field-of-view images, there is also apparent increased signal abnormality on fluid sensitive sequences within the medial head of the gastrocnemius on the left which is also nonspecific but may represent a mild strain. There is also increased bone marrow signal abnormality within the medial aspect of the tibial plateau bilaterally, left greater than right. This is nonspecific but could also represent stress reaction, particularly if the patient has pain localizing to these areas.
Findings indicating stress reaction of the right tibia as described above. No discrete fracture line is identified at this time. Other findings as described above.