CRCM  Vol.4 No.10 , October 2015
Stress Fracture of Bilateral Distal Tibia Provoked by Stair Climbing
Abstract: Background: Stress fractures are fatigue-induced, very small cracks in the bone caused by repetitive application of force and most often seen in the weight-bearing bones of the lower extremities of athletes or military recruits. Case Report: A 47-year-old postmenopausal and heavy smoker woman complained of localized sensitivity on the distal-anterior and medial surfaces of both tibiae, which had been ongoing for 1 month. She moved to a flat at 5th-floor without an elevator a year ago. Bilateral stress fractures were diagnosed by radiographs and confirmed by Magnetic Resonance Imaging (MRI). She was suggested to restrict activities and to use crutches until the symptoms subsided. Bilateral ankle joint pneumatic brace with full heel support was applied. The patient was followed one year after diagnosis. At the 2-month follow-up examination, the patient was pain free and planning to move to a new house. Conclusions: Several risk factors have been defined in the pathogenesis of stress fracture. In the present case, the acute phase had passed and diagnosis could be made from the direct radiographs. Although extremely rarely seen, tibia distal stress fracture should be kept in mind in the differential diagnosis of patients with the relevant risk factors who present with tibia distal localized pain.
Cite this paper: Arslan, A. , Utkan, A. and Koca, T. (2015) Stress Fracture of Bilateral Distal Tibia Provoked by Stair Climbing. Case Reports in Clinical Medicine, 4, 337-341. doi: 10.4236/crcm.2015.410067.

[1]   Boden, B.P., Osbahr, D.C. and Jimenez, C. (2001) Low Risk Stress Fractures. American Journal of Sports Medicine, 29, 100-111.

[2]   Patel, D.S., Roth, M. and Kapil, N. (2011) Stress Fractures: Diagnosis, Treatment, and Prevention. American Family Physician, 83, 39-46.

[3]   Fayad, L.M., Kamel, I.R., Kawamoto, S., Bluemke, D.A., Frassica, F.J. and Fishman, E.K. (2005) Distinguishing Stress Fractures from Pathologic Fractures: A Multimodality Approach. Skeletal Radiology, 34, 245-259.

[4]   Iwamoto, J., Sato, Y., Takeda, T. and Matsumoto, H. (2011) Analysis of Stress Fractures in Athletes Based on Our Clinical Experience. World Journal of Orthopaedics, 2, 7-12.

[5]   Scaglione, M., Fabbri, L., Dell’Omo, D., Gambini, F., Di Rollo, F. and Guido, G. (2014) A Case of Bilateral Stress Fractures in an Old Woman: Three Years of Pain. Clinical Cases in Mineral and Bone Metabolism, 11, 149-152.

[6]   Batt, M.E., Ugalde, V., Anderson, M.W. and Shelton, D.K. (1998) A Prospective Controlled Study of Diagnostic Imaging for Acute Shin Splints. Medicine & Science in Sports & Exercise, 30, 1564-1571.

[7]   Spitz, D.J. and Newberg, A.H. (2002) Imaging of Stress Fractures in the Athlete. Radiologic Clinics of North America, 40, 313-331.

[8]   Boden, B.P. and Osbahr, D.C. (2000) High Risk Stress Fractures: Evaluation and Treatment. Journal of the American Academy of Orthopaedic Surgeons, 8, 344-353.

[9]   Kahanov, L., Eberman, L.E., Games, K.E. and Wasik, M. (2015) Diagnosis, Treatment, and Rehabilitation of Stress Fractures in the Lower Extremity in Runners. Open Access Journal of Sports Medicine, 6, 87-95.

[10]   Rome, K., Handoll, H.H. and Ashford, R. (2005) Interventions for Preventing and Treating Stress Fractures and Stress Reactions of Bone of the Lower Limbs in Young Adults. Cochrane Database of Systematic Reviews, 2, Article ID: CD000450.