Stress fractures in this population that are not identified and managed in a timely fashion can progress to more serious fractures and complications (eg, risk of fatty emboli in completed femoral shaft fractures). Preventive strategies, including identifying and modifying risk factors, may help deter progression to complete fracture [42,63,64]. Certain stress fractures are considered high risk based on a tendency for nonunion or delayed union. High-risk stress fractures include the anterior tibial diaphysis, lateral femoral neck and femoral head, patella, medial malleolus, navicular, fifth metatarsal base, proximal second metatarsal, tibial hallux sesamoid, and talus [65]. 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. Stress (Fatigue-Insufficiency) Fracture 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 or MRI [23]. The benefit of CT seems to lie in its specificity, ranging from 88% to 98% in a recent meta-analysis regarding accuracy of imaging modalities for lower extremity stress fractures and thus may confirm a finding suspected to represent stress fracture on MRI [24].
Stress Fatigue Insufficiency Fracture Including Sacrum Excluding Other Vertebrae PCAs. Stress fractures in this population that are not identified and managed in a timely fashion can progress to more serious fractures and complications (eg, risk of fatty emboli in completed femoral shaft fractures). Preventive strategies, including identifying and modifying risk factors, may help deter progression to complete fracture [42,63,64]. Certain stress fractures are considered high risk based on a tendency for nonunion or delayed union. High-risk stress fractures include the anterior tibial diaphysis, lateral femoral neck and femoral head, patella, medial malleolus, navicular, fifth metatarsal base, proximal second metatarsal, tibial hallux sesamoid, and talus [65]. 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. Stress (Fatigue-Insufficiency) Fracture 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 or MRI [23]. The benefit of CT seems to lie in its specificity, ranging from 88% to 98% in a recent meta-analysis regarding accuracy of imaging modalities for lower extremity stress fractures and thus may confirm a finding suspected to represent stress fracture on MRI [24].