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Zeitgemäße bildgebende Untersuchung bei (vermuteter) Stressfraktur

Contemporary imaging examinations for (suspected) stress fractures

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Zusammenfassung

Die Stressfrakturen gehören zur Gruppe der atraumatischen Frakturen. Ihnen liegt eine gering einwirkende und repetitive Belastung zugrunde, und unter physiologischen Umständen würde keine Fraktur zustande kommen. Die konventionelle Röntgenuntersuchung ist weiterhin die initiale bildgebende Untersuchung, wenn der Verdacht auf eine Stressfraktur besteht. Die MRT ist hingegen der Goldstandard und dient u. a. zum Ausschluss anderer pathologischer Veränderungen. Die CT soll hinzugezogen werden, wenn der MRT-Befund unklar ist. Neue Techniken wie die „dual-energy computed tomography“ (DECT) und das „magnetic resonance bone imaging“ (MR-Bone) sollten zukünftig in der Praxis häufiger angewendet werden und an Bedeutung für die korrekte Diagnosestellung gewinnen.

Abstract

Stress fractures belong to the group of atraumatic fractures. A low-impact and repetitive load is the underlying cause and no fracture would occur under physiological circumstances. The conventional X‑ray examination remains the initial imaging modality when a stress fracture is suspected. In contrast, magnetic resonance imaging (MRI) is the gold standard and is also used to rule out other pathological changes. Computed tomography (CT) should be included if the MRI findings are unclear. New techniques, such as dual energy computed tomography (DECT) and magnetic resonance bone imaging (MR bone) should be used more frequently in practice in the future and become increasingly more important for the correct diagnosis.

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Danksagung

Wir danken Herrn Kilian Solty, GE HealthCare Deutschland für die Implementierung der Bone-MR-Techniken und für die Durchsicht des Manuskripts.

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Authors and Affiliations

  1. Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland

    Andrés Arévalo Hernández & Marc-André Weber

  2. Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Rostock, Deutschland

    Thomas Mittlmeier

Authors
  1. Andrés Arévalo Hernández
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  2. Thomas Mittlmeier
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  3. Marc-André Weber
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Correspondence to Andrés Arévalo Hernández.

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Interessenkonflikt

A. Arévalo Hernández, T. Mittlmeier und M.-A. Weber geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Thomas Mittlmeier, Rostock

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Arévalo Hernández, A., Mittlmeier, T. & Weber, MA. Zeitgemäße bildgebende Untersuchung bei (vermuteter) Stressfraktur. Unfallchirurgie 126, 831–838 (2023). https://doi.org/10.1007/s00113-023-01358-1

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  • DOI: https://doi.org/10.1007/s00113-023-01358-1

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