Issn Print: 0143-3636

Publication Date: 2001/03/01


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Clinical value of bone scintigraphy in suspected tibial stress fractures

J. A.E. Dutton; S. E. Bromhead; A. R. Menzies; A. M. Peters

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Excerpt

This study aimed to correlate scintigraphic appearances in exercise-related lower leg pain with clinical outcome in military recruits. Views of the lower limbs, using 400 MBq 99Tcm-methylene diphosphonate (MDP), were obtained in 63 soldiers. Images were categorized according to Zwas et al. (J Nucl Med 1987; 28: 452-457). Results were compared with clinical outcome.
Thirty-nine patients had stress fractures; 14 were grade III or IV, and 25 were grade I or II. Nine of the remaining patients had normal scans, and 15 had ‘shin splints’. Focal abnormalities correlated well with the site of clinical symptoms in most cases. of those with grade I or II, only eight made a full recovery. Two left the service for personal reasons, and two have incomplete records. Thirteen were discharged on medical grounds with recurrent pain. In contrast, of those with grade III or IV, only three were discharged with leg pain. Three left for other reasons and one recruit is still being treated. Thus 13 out of 21 with grade I/II were discharged on medical grounds compared with three out of 10 with grade III/IV (0.1>P>0.05).
In conclusion, the clinical outcome is better for military recruits with higher rather than lower grade stress fractures.
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