Transcript
Ruling out Fractures
Use of magnetic resonance imaging to diagnose fracture in
light of negative plain films
Case Report
• 48 year old white female with no history of trauma reports having 2-3 months history of discomfort in the right foot and ankle
• A presumptive diagnosis of common heel pain or Plantar fasciitis is made
Case Report
• Plain films show no pathology to foot or ankle
• Patient has continued pain after a period of soft casting of the site and Non-steroidal anti-inflammatory therapy
Case Report
• A 3-phase technetium™ bone scan is done to look for other pathology and is hot at the calcaneus of the right foot.
• A magnetic resonance imaging study is done and shows a through and through calcaneal fracture at the midbody aspect of the tuber
Imaging• Plain film read as
no pathology although a subtle area of sclerosis is noted at the superior calcaneus
3-phase technetium™ bone scan
• Scan is hot throughout the calcaneus
MR Images
• Clear line of fracture seen through the body of the os calcis
MR Images
MR Images
Conclusions
• The use of the MR scan in light of negative films allowed visualization of the fracture
• Continued symptomotology with negative films would indicate further studies
• As the 3-phase scan didn’t locate the fracture, the magnetic resonance imaging was actually more cost- effective
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