(Fig 5-B.17) Stress Response and Stress Fracture in Cancellous Bone

https://youtu.be/tn8LqGn-7dU

https://youtu.be/9qehWGE9dp4

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✅ Subarticular Stress Response

• Subarticular stress response, stress response, and stress reaction are terms that refer to pathologic findings that can result from either repetitive stress on normal bone, commonly referred to as fatigue stress response, or normal stress on abnormally weakened bone, commonly referred to as insufficiency stress response.

• Initial Presentation: A stress response initially presents as bone marrow edema-like changes in signal intensity, sometimes accompanied by cortical thickening without a discrete hypointense line.

 

✅ Progression to Stress Fracture

• With continued stress, cortical disruption and a stress fracture may occur. 
• These appear on radiographs and CT images as linear sclerosis perpendicular to the trabeculae and parallel to the articular surface, and on MR images as a fracture line surrounded by edema-like marrow signal intensity.

 

References

• AJR 2019; 213:963–982

 

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#StressResponse, #StressFracture, #SubchondralLevel, #BoneMarrowEdema, #CorticalThickening, #FatigueStressResponse, #InsufficiencyStressResponse, #Radiographs, #CTImages, #MRImages