Ali TÜRK, Ulaş CAN, Özlem SAYGILI, Ömer TAŞER, Hüseyin AKCAN

Tibia Longitudinal Stres Kırığı: Manyetik Rezonans Görüntüleme ve Bilgisayarlı Tomografi Bulguları

22 yaşında profesyonel basketbol oyuncusu erkek hasta, bir haftadır süregelen eforla oluşan sol bacakta ağrı şikayeti ile ortopedi kliniğine başvurdu. İki yönlü kruris grafisinde eski fibula kırığına bağlı değişiklikler dışında patolojik bulgu izlenmezken üç fazlı kemik sintigrafisinde tibiada vertikal uzanımlı aktivite artışı saptandı. Çok kesitli Bilgisayarlı Tomografi ÇKBT incelemesinde tibia orta-distal diafiz anteromedial yüzde kraniokaudal 9 cm’lik segmentte kortikal kleft saptandı. Magnetik Rezonans Görüntülemede MRG tibiada kortikal klefte eşlik eden kemik iliği ödemi ve yumuşak doku değişiklikleri mevcuttu. Radyolojik bulgular ışığında tibiada longitudinal stres kırığı tanısı konuldu. İstirahat ve medikal tedavi ile hastanın şikayetleri belirgin geriledi ve bir ayın sonunda aktif spor yaşantısına geri döndü. Olgu sunumumuzda literatürde az rastlanan tibia longitudinal stres kırığının direkt grafi, ÇKBT, MRG ve sintigrafi bulguları literatür bulguları eşliğinde tartışılmıştır

Tibial Longitudinal Stress Fracture; Mri and Ct Findings

A male professional basketball player was admitted to our orthopedic department with complaints of severe pain at his left lower leg with duration of one week. There were no apparent acute pathologic findings at cruris X-Ray in standart anteroposterior and lateral projections, except changes related to old fibula diaphyseal fracture. Vertically oriented increased activity was detected with three-phase bone scintigraphy. In computed tomography CT examination, a 9 cm craniokaudal cortical cleft was detected at the anteromedial surface of mid-distal tibial diaphysis. Tibial cortical cleft and concomitant bone marrow edema accompanied by soft tissue changes were detected with magnetic resonance imaging MRI . Tibial longitudinal stress fracture was diagnosed with these findings. The complaints of the patient markedly improved with rest and conservative treatment. He returned to active sports at the end of a month. In this case report, direct X-Ray, CT scan, MRI and scintigraphy findings of tibial longitudinal stress fracture are presented and discussed in the light of similar reports

Keywords:

tibia, longitudinal, fracture, MRI, CT,

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