Use of ultrasound in early detection of stress fractures of the medial tibial plateau

The purpose of this investigation was to determine whether ultrasound offers a reliable technique for the detection of stress fractures of the medial tibial plateau (MTP). This study further considered whether identification of MTP stress fractures by ultrasound occurred prior to that by radiographs. Fifty-four male military basic trainees who presented with knee pain were evaluated with ultrasound applied to the medial aspect of the proximal tibia. Thirty-eight of these individuals complained of pain at the medial tibial plateau upon application of ultrasound, with 34 (89.5 per cent) subsequently demonstrating radiographic evidence of MTP stress fracture. One hundred per cent of the 16 patients who did not experience pain with application of ultrasound did not show evidence of MTP stress fracture, radiographically. The overall accuracy of detecting MTP stress fractures with ultrasound in patients with knee pain was 92.6 per cent. Ultrasound offers a safe, inexpensive, reliable technique for detecting MTP stress fractures prior to identification with radiographs, and is a useful modality in the clinical evaluation of patients with vague, poorly localized knee complaints.