Stress fractures: clinical features and investigation.

In the period 1972 to 1989, 92 sports men and women were treated for stress fracture. Symptoms included localized bony pain aggravated by activity. Physical examination demonstrated point tenderness and pain on loading the bone. The majority of fractures were in the lower limbs but axial skeleton and upper limb bones were also affected. Radiographs showed evidence in only 49% of fractures. Bone scanning, on the other hand, was found to be very accurate and indicative immediately. Therefore, patients with a clinical history of stress fracture and a normal radiograph should undergo a bone scan.