Proximal tibial stress fracture

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Factory worker complains of pain around the knee for three months.

Patient Data

Age: 65 years
Gender: Male
x-ray

A thin sclerotic line is noted at the medial aspect of proximal tibia parallel to tibial plateau.

A thin transverse sclerotic line is noted at the medial aspect of proximal tibia reaching medial tibial cortex with surrounding edema, mostly representing a stress fracture.

Osteoarthritic changes of the knee joint with thinned tibiofemoral articular cartilage showing few erosions.

An intrasubstance high signal intensity of posterior horn of medial meniscus reaching articular surfaces, suggestive of complex tear. Radial tear is also noted at the middle of the medial meniscus reaching its capsular attachment.

Sprained anterior cruciate ligament.

Mild knee joint effusion.

Case Discussion

MRI shows proximal tibial stress fracture. It typically involves the medial tibial condyle.

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