PEDIATRIC STRESS FRACTURES

Stress fractures are fractures of bones that occur due to prolonged, repetitive mechanical loads that are less than the force that would typically cause a complete fracture. There are two subtypes: insufficiency fractures and fatigue fractures. Fatigue fractures are frequently seen in the lower extremities in healthy bones due to unusual mechanical loads. They are primarily seen in young adults, athletes, dancers, and soldiers. Insufficiency fractures develop due to normal or traumatic loads on abnormal bone structures. Although there are various risk factors, they are more common in older patients with osteoporosis. They are usually seen in the pelvis and its surroundings. The first step in diagnosis is plain radiography. It can reveal linear sclerosis and periosteal reaction before a significant fracture develops. However, fe-cal material, bowel loops, and vascular calcifications may obscure the fracture line. Advanced imaging methods such as bone scintigraphy and magnetic resonance imaging (MRI) should be requested early in clinical suspicion. MRI can detect early bone marrow edema, periosteal edema, and intracortical sig-nal abnormalities. Clinical suspicion is vital for the correct diagnosis and treatment of stress fractures, which are difficult to diagnose and often overlooked.