Leg and Foot Stress Fractures: Difference between revisions
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*Pain with WB | *Pain with WB | ||
*Recent increase in activity (i.e. high intensity and/or high frequency) | *Recent increase in activity (i.e. high intensity and/or high frequency) | ||
*Gradual onset | *Gradual onset (Van der Velde et al 1999)<br> | ||
*Begins as pain with stress, eventually progressing to pain at rest and during the night | *Begins as pain with stress, eventually progressing to pain at rest and during the night | ||
Revision as of 20:06, 8 July 2011
Original Editors
Lead Editors - Holly Pulket, Corin Arundale, Brenda Walk, Brittany Buenteo, Melissa Osti
Search Strategy[edit | edit source]
6/10/11 -
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Definition/Description[edit | edit source]
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Epidemiology/Etiology[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Outcome Measures[edit | edit source]
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Examination[edit | edit source]
When evaluating an adult with a LE stress fracture a thorough history is important.
Key history findings of an individual with a stress fracture (Lassus):
- Pain with WB
- Recent increase in activity (i.e. high intensity and/or high frequency)
- Gradual onset (Van der Velde et al 1999)
- Begins as pain with stress, eventually progressing to pain at rest and during the night
During the physical examination, the clinician will want to take an impairment based approach. Important aspects of the evaluation will include observation, gait analysis, leg length discrepancy, tenderness with palpation, and ROM (Duran-Stanton et al 2011). Patients with stress fractures typically will have tenderness to palpation and edema in surrounding soft tissues (Lassus). According to Hatch et al 2007, during the physical examination it may be important to perform all of the following: a neurologic screen for sensation, a vascular examination (capillary refill and LE pulses), inspect the skin for deformity, edema, or ecchymosis, and ROM to determine if there is a disproportionate amount of pain with movement.
In regards to navicular stress fxs (which is one of the most common types of foot stress fxs), foot shape has been implicated in the past as a risk factor but evidence is inconsisent (Oddy et al 2009, Tuan et al 2004). Injuries appear to occur in patients with pes planus, pes cavus, and normal feet.
Radiographs still are the first tool used for the diagnosis of stress fractures (Lassus). Stress fractures usually don't appear on xrays for two to six weeks (Hatch, Lassus) but when they are visible they will appear as a radiolucent line.
Medical Management
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Physical Therapy Management
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