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Asymptomatic Tibial Stress Reactions: MRI Detection and Clinical Follow-Up in Distance Runners

¹ Department of Radiology, Stanford University Medical Center, 300 Pasteur Dr., Stanford, CA 94305-5105.
² Present address: Franklin & Seidelmann Virtual Radiologists, El Dorado Hills, CA.
³ Department of Orthopaedic Surgery, Division of Physical Medicine and Rehabilitation, Stanford University Medical Center, Stanford, CA 94305-5336.
⁴ Sand Hill Imaging, Menlo Park, CA 94025.
⁵ Department of Orthopaedic Surgery, Division of Sports Medicine, Burnham Pavilion, Stanford University, Stanford, CA 94305-6175.

Abstract

OBJECTIVE. The purpose of this study was twofold: to determine if asymptomatic elite distance runners exhibit stress reactions of the tibia on MR images and to determine if the presence of bone stress lesions predicts later development of symptomatic tibial stress injuries.

CONCLUSION. Signs of a tibial stress reaction were found on MRI in 43% of the 21 asymptomatic college distance runners in this study. The presence of these changes was not found to be a predictor of future tibial stress reactions or stress fractures. Our findings underscore the importance of correlating MRI findings with clinical findings before making therapeutic decisions.

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