Because standard planar whole body bone scintigraphy is often nonspecific and supplemental imaging is frequently required, there is consensus in the literature that MRI should supersede bone scintigraphy as the imaging examination of choice for suspected stress fracture when radiographs are negative [31]. CT Area of Interest With IV Contrast There is no relevant literature to support the use of CT area of interest with IV contrast because it does not provide added information over noncontrast imaging with regard to stress injury. CT Area of Interest Without and With IV Contrast There is no relevant literature to support the use of CT area of interest without and with IV contrast because it does not provide added information over noncontrast imaging with regard to stress injury. CT Area of Interest Without IV Contrast CT is not supported as the next imaging study for suspected stress fractures following radiographs but may offer an adjunctive role when other imaging modalities are equivocal [22]. Although superior to radiography, it is less sensitive than nuclear scintigraphy and MRI [23]. CT is useful in cases where MRI results are equivocal. MRI Area of Interest Without and With IV Contrast There is no relevant literature to support the use of MRI area of interest without and with IV contrast because it does not provide added information over noncontrast imaging with regard to stress injury. MRI Area of Interest Without IV Contrast MRI outperforms radiography, bone scintigraphy, and CT with recent literature supporting MRI as the procedure of choice for making an early diagnosis of both fatigue and insufficiency fractures [15,22,23,29-39]. MRI of an osseous stress injury contains prognostic as well as diagnostic information [41,42].
Stress Fatigue Insufficiency Fracture Including Sacrum Excluding Other Vertebrae PCAs. Because standard planar whole body bone scintigraphy is often nonspecific and supplemental imaging is frequently required, there is consensus in the literature that MRI should supersede bone scintigraphy as the imaging examination of choice for suspected stress fracture when radiographs are negative [31]. CT Area of Interest With IV Contrast There is no relevant literature to support the use of CT area of interest with IV contrast because it does not provide added information over noncontrast imaging with regard to stress injury. CT Area of Interest Without and With IV Contrast There is no relevant literature to support the use of CT area of interest without and with IV contrast because it does not provide added information over noncontrast imaging with regard to stress injury. CT Area of Interest Without IV Contrast CT is not supported as the next imaging study for suspected stress fractures following radiographs but may offer an adjunctive role when other imaging modalities are equivocal [22]. Although superior to radiography, it is less sensitive than nuclear scintigraphy and MRI [23]. CT is useful in cases where MRI results are equivocal. MRI Area of Interest Without and With IV Contrast There is no relevant literature to support the use of MRI area of interest without and with IV contrast because it does not provide added information over noncontrast imaging with regard to stress injury. MRI Area of Interest Without IV Contrast MRI outperforms radiography, bone scintigraphy, and CT with recent literature supporting MRI as the procedure of choice for making an early diagnosis of both fatigue and insufficiency fractures [15,22,23,29-39]. MRI of an osseous stress injury contains prognostic as well as diagnostic information [41,42].