Fig. 11
From: Stress fracture of the pelvis and lower limbs including atypical femoral fractures—a review
Middle-aged female runner presenting with focal calf pain. Initial radiographs (a, AP view shown) were normal. MRI 2 weeks after the initial radiographs (b, c, coronal and axial PD-FS images) shows a periosteal reaction and widespread soft tissue oedema around the fibula shaft typical for a stress fracture (see arrows). Radiographic follow-up 3 weeks after this (d) shows a periosteal reaction of the fibula where pain was initially indicated (arrow). Radiographs are insensitive for stress fractures early on; MRI shows soft tissue oedema and a periosteal reaction and is the investigation of choice if radiographs are negative