Stress fractures in athletes.

The differential diagnosis includes musculo-tendinous injury, tibial compartment syndrome, tenosynovitis, intermittent claudication of the athlete and stress fracture. A presumptive diagnosis of stress fracture is based on the history and physical findings. In the past, confirmation of stress fractures has been delayed until x-rays showed an abnormality, often from three weeks to three months after the onset of symptoms. We have found the radionuclide bone scan to be more sensitive, allowing earlier confirmation of stress fractures in athletes and thus avoiding prolonged disability.