Femoral neck stress fractures: MRI risk factors for progression.
Steele CE, et al.
J Bone Joint Surg Am. (2018); 100(17):1496–1502
Over 13 years, 798 MR studies of active duty military personnel were performed for suspected stress fracture of the femoral neck. Three hundred five exams (38%, mean age 22.6 years, 98% male) found unilateral femoral neck stress reactions/fractures. These subjects were grouped by MR findings. Those with a visible fracture line ≥50% of the femoral neck width, n = 48 (16%), were treated surgically without delay. The remaining 257 patients with either edema-like marrow signal, but no visible fracture line (n = 139) or a fracture line <50% femoral neck width (n = 118) were treated conservatively with non-weightbearing for 6 weeks. All of the stress fracture lines were on the compression side of the femoral neck. A 6 week follow up MR was performed in 194 (76%) of the non-operated patients. All of the patients with an initial MR showing edema-like marrow signal...