Female 20 years old; Reason: Stress fracture distal tibia History: spontaneous pain and swelling. There is edema within the distal tibial metaphysis. There is also periosteal reaction along the posterior tibial metaphysis. While we see no discrete fracture line there is a poorly defined band-like focus of relatively low signal positioned within the edema that may represent early findings of a stress fracture. There is mild edema in the adjacent soft tissues and also posteriorly within Kager's fat pad. There is also mild edema within the distal fibula, calcaneus, and cuboid, which may reflect additional sites of relatively mild stress reaction/altered biomechanics. There are small tibiotalar and subtalar joint effusions. We see no osteochondral defects. The lateral collateral ligament complex appears intact. The distal tibiofibular syndesmotic complex is intact. The visualized component of the deltoid ligament appear intact. The spring ligament components appear intact. The Achilles tendon appears normal. There is a small amount of fluid within the sheaths of the medial tendons, which otherwise appear intact. The peroneal tendons appear intact. The anterior tendons are intact.
1. Edema within the distal tibial metaphysis is nonspecific but compatible with a stress reaction/early stress fracture. Additional milder edema is noted in the distal fibula, calcaneus, and cuboid, perhaps representing additional sites of relatively mild stress reaction/altered biomechanics.2. Other findings as above.