I had an MRI for a possible stress fracture, I have the results but don’t meet w/ the doctor until tomorrow. What does this mean in English. I’m hoping to still do IMFL in 3 weeks.
MRI OF THE RIGHT LEG WITH AND WITHOUT CONTRAST
10/04/06
INDICATION:
Abnormal x-ray with stress type changes. Exclude soft tissue lesion in adjacent fibula.
TECHNIQUE:
Prior to and following intravenous infusion of 16.0 cc gadolinium DTPA, multisequence, multiprojectional imaging is obtained through the leg from the knee to the ankle.
FINDINGS:
Abnormal signal and enhancement is seen about the proximal shaft of the tibia with marked cortical thickening along the tibial shaft. There is no discrete fracture line but this is suggestive of a stress type injury. In addition, there is marked thickening of the cortex of the fibula, and at the proximal third of the fibula, there is some subtle signal alteration again suggesting stress type injury. I do not see a significant soft tissue abnormality associated with the cortical finding on the recent plain radiographs (comparison to 10/3/06). Rather the finding on the plain radiograph appears to correspond to the site of penetrating vessel, a normal anatomic consideration exaggerated by the cortical thickening.
IMPRESSION:
Stress type changes in the proximal tibia and fibula without discrete fracture. The saucer-shaped cortical change demonstrated among the cortical thickening at the proximal shaft of the fibula appears to represent the site of a penetrating vessel.
You have no stress fx, but, are you having pain in the area? (behind the calf near the bone)? Why did you get this done (except for the anatomic varient of the nutrient artery through the cortex on plain films)? Lots of marathon runners have cortical thickening from the constant pounding from running: means nothing. Didn’t even comment on any marrow edema, which is a more common, early stress injury type pattern. Rest up though - IMFL is not completely out, but discuss this with your physician (hopefully an athlete that understands your 1 year investment in the race).
Good luck!
edit: also, it is titled “MRI without contrast” yet they mentioned gadolinium contrast injection? So, which was it
Yes, I was having severe pain behind the calf near the bone. I was unable to put weight on it for 24 hours and unable to walk without crutches for 48 hours.
Yes, the doctor is a triathlete and highly recommended by several runners as well as other doctors.
edit: also, it is titled “MRI without contrast” yet they mentioned gadolinium contrast injection? So, which was it
It was entitled “with and without contrast” so it was both. Hugh apparently edited this after your remark.
I agree, the “import of this” depends upon what the complaints were and what the physical exam showed. It is not possible for anyone here to tell him what it means to him and his race.
Hmmm … severe, immediate pain like that is usually not bone, but muscular/soft tissue. Hope all goes well. Trust your doc’s instinct then with all the data he has (X-ray, MRI, hands on, etc.) Good luck!
Abnormal signal and enhancement is seen about the proximal shaft of the tibia with marked cortical thickening along the tibial shaft. There is no discrete fracture line but this is suggestive of a stress type injury
Though the rad didn’t specifically say bone marrow edema (or not, which would be a pertinent positive or negative finding), I couldn’t say that this “abnormal signal” may or may not include some bone marrow edema. One way to read it would be abnormal signal (somewhere in the prox. shaft) AND cortical thickening.
