Symptoms of stress fracture

Since a fatigue fracture develops insidiously rather than as a result of an acute traumatic event, other symptoms are also characteristic of a stress fracture. In contrast to a normal fracture, where patients report a sudden pain event in the context of an injury, a stress fracture initially causes only slight pain. This pain often exists only under stress and only later at rest.

Other conceivable symptoms of a stress fracture are swelling over the corresponding bone, as well as redness and overheating. The load-bearing capacity of the corresponding structures also decreases gradually, so that those affected do not immediately think of a bone fracture. Accordingly, the diagnosis is often made with a delay.

In contrast to a normal bone fracture, a stress fracture is not associated with an acute pain event. Instead, the affected person notices only slight pain at first, which only occurs under stress. With prolonged stress, the pain can become stronger and eventually occur at rest. The pain can range from sharp to dull.

Diagnosis of a stress fracture

Due to the protracted course of the disease, a stress fracture is often detected and diagnosed late. Often the symptoms such as pain, swelling and overheating are initially thought of as rheumatic complaints. An exact anamnesis and the pattern of overstrain are therefore very important for the diagnosis.

To confirm the suspicion, imaging must then be performed. X-ray imaging is only of limited use here; especially in the early stages of a stress fracture, the fine fracture lines are often not visible on X-ray. A stress fracture can be better assessed on CT.

However, the best way to detect a stress fracture or its precursors (such as microfractures) is by MRI (magnetic resonance imaging) or skeletal scintigraphy. In some cases, other diseases such as bone inflammation (osteomyelitis) or benign and malignant bone tumors must be excluded. In some cases, this can be done by taking a blood sample or a tissue sample.