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Tibial stress fracture differential diagnosis

Posted , 2 users are following.

sean40751
sean40751

Hi, I'm 20, male, and do running as a sport. I felt pain in my left tibia after running, went to a GDP, had an xray (which didn't show anything) and then an MRI, as I had a lump where the injury was (first a soft swelling and then firm). The radiologist thought it was a primary bone tumour and I was referred to an orthopaedian oncologist. The specialist said it was a misdiagnosis and said it's just a tibial stress fracture. To make sure it is not anything else, he booked me a CT. Then, once I had had the CT, he told me it's a stress fracture but there is also something abnormal little which might be a resolved osteoid osteoma (or what's left of it). He reassured me it's definitely no bone cancer and that it is just a stress fracture and that I maybe had had an osteoid osteoma which is now resolved.

It's been eight months since I had my injury. I occassianlly still have some pain. Not severe, but I feel it. The bone has started to remodel but it takes ages it seems. I can still feel the hard callus. It is not palpable anymore though unless you look very closely and now what you are looking for.

I have a few questions:

1. If he says it's just a stress fracture, is he just saying it if he's really sure? Is the CT/ MRI combination reliable to exclude a tumour?

2. Is it normal to have occasional mild pain where you had a stress fracture (bearing in mind it's eight months since I got the injury)?

3. Can remodelling really take so long?

4. Is the pain real or is phantom pain (cause I heard about that)?

5. If he weren't absolutely sure it's not a tumour, would he have booked me further scans? Or would a doctor maybe take the risk if chances are only little it's a tumour?

Thanks a lot for any replies. Honestly I have barely slept the last few months, I wake up at least every second night with nightmares

2 likes, 3 replies

3 Replies

  • richard89308
    richard89308 sean40751

    Posted

    thats a lot of questions!  You have had a second opinion, I should be happy with that and not worry.  Bones build up and break down material to mend fractures so that is maybe what you noticed. Fractures are a painful experience.  My leg fracture took 3 months in plaster.  Be patient. As a runner you risk stress fractures and you were unlucky on this occasion.

    Richard

  • sue21470
    sue21470 sean40751

    Posted

    My husband fell and hurt his tibia and was diagnosed at A&E with a soft tissue swelling and haemotomia. An xray did not show a fracture. He has night pain since the fall but after 1 month this is reducing. Meds include paracetomol  and co-codomal as advised by GP. The Tibia is sensitive to painful injuiries. Rest and warm hot water bottles help 2. Pillows support both legs 2. Best wishes for a full recovery2.
    • sue21470
      sue21470

      Posted

      sorry now advised to follow rest ice elevation and if needed rereferral to Doctors.
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