Taking the Stress out of Evaluating Stress Injuries in Children

Camilo Jaimes, Mauricio Jimenez, Nogah Shabshin, Tal Laor, Diego Jaramillo
2012 Radiographics  
Pediatric stress injuries result from a mismatch between (a) the burden of activity on growing bone and cartilage and (b) their intrinsic biomechanical properties. Although the presentation of stress injuries varies with the specific physical activity and the site of injury, in children it varies primarily with the degree of skeletal maturation. During the past several years, there has been a substantial increase in the incidence of pediatric stress injuries. The differential diagnosis of a
more » ... diagnosis of a stress injury in a child or adolescent can be challenging because the injury sometimes can appear aggressive at imaging assessment. Awareness of the spectrum of imaging features of stress injuries can help the radiologist to reach the correct diagnosis and prevent unnecessary anxiety. This review depicts the range of stress injuries in children and adolescents in various anatomic locations, with emphasis on their appearances at magnetic resonance imaging. Abbreviations: GRE = gradient-recalled echo, STIR = short inversion time inversion-recovery RadioGraphics 2012; 32:537-555 • Published online 10.1148/rg.322115022 • Content Codes: RadioGraphics 2012; 32:537-555 • Published online 10.1148/rg.322115022 • Content Codes: Page 538 When a bone is subjected to stress, it responds initially with accelerated cortical resorption and remodeling of the haversian systems, a response that leads to weakening of the cortex. Persistent stress results in osteoclastic resorption outpacing osteoblastic repair, a situation that leads to even further weakening and fracture if the stressor is not curtailed (6).
doi:10.1148/rg.322115022 pmid:22411948 fatcat:m4utenwirff4xiu6lj3poj6u74