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Radionuclide Bone Scintigraphy
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Kanhaiyalal Agrawal, Gopinath Gnanasegaran
Stress fractures are fractures that occur in normal bone due to repetitive activity or overuse. In contrast, an insufficiency fracture is due to normal stress in a pathological or weak bone. Early diagnosis helps in early recovery and prevention of frank fractures. The bone scan is positive from the very early, or initial, phase of stress reaction and is extremely sensitive. Further, as stress reactions may involve multiple sites, the whole-body assessment helps detect additional areas. The uptake is usually focal intense with a shape ranging from oval to fusiform, depending upon the severity (Figure 11.15). The first two phases on the bone scan typically show increased hyperaemia in a stress fracture. In shin splint or tibial periostitis, there is micro-avulsion of fibres connecting periosteum to bones. Hence, periostitis is seen as linear tracer uptake, typically in the posterior medial aspect of the tibia involving more than a third of the tibia. The first two phases of the scan are usually normal.
Repetitive TasksRisk Assessment and Task Design
Published in R. S. Bridger, Introduction to Human Factors and Ergonomics, 2017
Repeated, heavy loading is essential for the proper formation and maintenance of bone. Wolff's law states that bone grows in proportion to and in opposition to the forces imposed on it. Under repeated loading, particularly of the lower extremities, stress fractures can occur. Stress fracturing, like many WMSDs, is a process rather than an event (Pitner, 1990). Repeated loads (below the threshold for acute fracture) damage bone eventually leading to acute fracture. It is thought that these injuries are more likely to occur if the loading is accompanied by muscle fatigue.
Musculoskeletal system
Published in David A Lisle, Imaging for Students, 2012
Stress fractures occur due to repetitive trauma to otherwise normal bone, and are common in athletes and other active people. Certain types of stress fracture occur in certain activities, e.g. upper tibial stress fractures in runners, metatarsal stress fractures in marchers. Radiographs are often normal at the time of initial presentation; after 7–10 days, a localized sclerotic line with periosteal thickening is usually visible (Fig. 8.8). MRI is usually positive at the time of initial presentation, as is scintigraphy with 99mTc-MDP.
Promoting adaptive bone formation to prevent stress fractures in military personnel
Published in European Journal of Sport Science, 2022
Julie M. Hughes, Thomas J. O’Leary, Kristen J. Koltun, Julie P. Greeves
Bone adapts to mechanical loading by altering shape, size, microarchitecture, and density. New bone is formed on existing skeletal surfaces at sites of highest mechanical stress in a process of adaptive bone formation modelling (Hughes, Popp, Yanovich, Bouxsein, & Matheny, 2017). Adaptive bone formation increases bone strength and fatigue resistance (Warden et al., 2005). The same loading, or “osteogenic” exercise, might also cause microdamage to bone and development of a stress fracture through targeted remodelling, notably in those with narrower bones and thinner cortices (Beck et al., 2000). Stress fractures are particularly common in military recruits and athletes who engage in persistent and/or excessive training and cause significant morbidity, lost training time, and discharge from military service. Promoting the adaptive bone formation response to exercise is, therefore, an important approach for stress fracture prevention. This review proposes strategies to promote adaptive bone formation as a novel approach to mitigate the risk of stress fracture injuries during arduous military training and strengthen the skeleton of military personnel to withstand the physical and environment rigours of military service.
On biological availability dependent bone remodeling
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Areti Papastavrou, Ina Schmidt, Paul Steinmann
The female athlete triad, a syndrome of eating disorders, amenorrhoea and osteoporosis, has gained increasing importance in sports medicine in recent years. Athletes of all ages face special challenges when it comes to maintaining their health. While athletic activity can be beneficial in both the short and long term, female athletes with extreme sporting ambitions can face worsening health impacts. If, for example, the general calorie intake is restricted to maintain a low competition weight and the body is overstrained by vigorous training, damage to the body can potentially occur in the short and long term. Especially in sports such as hurdles running or figure skating, stress fractures occur more frequently due to osteoporosis, the loss of bone density.
Establishment of the simplified technique for estimating joint moments in foot during running†
Published in Footwear Science, 2018
Ayu Miura, Kenta Moriyasu, Tsuyoshi Nishiwaki
Among various lower extremity injuries, inflammation of ligaments and stress fracture are predominantly caused by long-distance running (van Gent et al., 2007). Stress fractures have been defined as partial or complete fractures of bone as a result of repetitive sub-maximal loading (Zadpoor & Nilooyan, 2011). Stress fractures most commonly occur at the tibial and metatarsal (mainly the second- and third-ray) bones (Gross & Bunch, 1989; Milner, Davis, & Hamill, 2006; Orava, Puranen, & Ala-Ketola, 1978).