F Rossi1, S Dragoni. 1. National Institute of Sports Medicine of the Italian Olympic Committee, Rome, Italy.
Abstract
OBJECTIVE: To introduce and emphasize the clinical and radiological findings of three talar body fatigue stress fractures in competitive athletes. DESIGN AND PATIENTS: Clinical and radiographic skeletal records of 24,562 athletes taken between 1962 and 2002 were retrospectively reviewed. Among these, 6851 files related to acute foot and ankle injuries or chronic post-traumatic sequelae were found. RESULTS: There were 925 (3.76%) stress fatigue fractures selected from the whole collection. Among these there were three cases (0.32%) of talar body stress fractures diagnosed in elite female gymnasts 15-17 years old. The negative first radiograph become positive 4-6 weeks later. Scintigraphy was positive at an early stage and consistent for the diagnosis. CT and MRI gave positive results 1-2 weeks after the beginning of symptoms which were always greatly diagnostic. CONCLUSIONS: The sports medicine literature lacks reports of talar body fatigue stress fractures. The poor initial sensitivity of radiography makes it problematic to establish an early diagnosis. A wise combination of scintigraphy, CT and MRI has therefore to be relied upon. Familiarity with this rare location for a stress fracture may prevent delayed diagnosis and long-lasting damage, both of which are important factors in competitive athletes.
OBJECTIVE: To introduce and emphasize the clinical and radiological findings of three talar body fatigue stress fractures in competitive athletes. DESIGN AND PATIENTS: Clinical and radiographic skeletal records of 24,562 athletes taken between 1962 and 2002 were retrospectively reviewed. Among these, 6851 files related to acute foot and ankle injuries or chronic post-traumatic sequelae were found. RESULTS: There were 925 (3.76%) stress fatigue fractures selected from the whole collection. Among these there were three cases (0.32%) of talar body stress fractures diagnosed in elite female gymnasts 15-17 years old. The negative first radiograph become positive 4-6 weeks later. Scintigraphy was positive at an early stage and consistent for the diagnosis. CT and MRI gave positive results 1-2 weeks after the beginning of symptoms which were always greatly diagnostic. CONCLUSIONS: The sports medicine literature lacks reports of talar body fatigue stress fractures. The poor initial sensitivity of radiography makes it problematic to establish an early diagnosis. A wise combination of scintigraphy, CT and MRI has therefore to be relied upon. Familiarity with this rare location for a stress fracture may prevent delayed diagnosis and long-lasting damage, both of which are important factors in competitive athletes.
Authors: G O Matheson; D B Clement; D C McKenzie; J E Taunton; D R Lloyd-Smith; J G MacIntyre Journal: Am J Sports Med Date: 1987 Jan-Feb Impact factor: 6.202