How are hip stress fractures classified based on MRI findings?

Updated: Jan 08, 2019
  • Author: Naveenpal S Bhatti, MD; Chief Editor: Sherwin SW Ho, MD  more...
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A study by Shin and Gillingham classified stress fractures based primarily on MRI findings. [10] The 3 basic categories were compression, tension, and displaced fatigue fractures. Compression side injuries were further subdivided on the basis of whether a fatigue line, which appears as a linear band of low-signal intensity lying perpendicular to the line of force across the femoral neck, was present.

The 2 subtypes are those that demonstrate a fatigue line less than 50% of the femoral neck width and those with a fatigue line greater than or equal to 50%. Tension side findings are subtle; their hallmark is increased signal intensity at the superior femoral neck on T2-weighted and short inversion time inversion recovery (STIR) images. Displaced fractures can be identified on plain radiographs.

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