Radionuclide Bone Imaging in the Detection of Stress Fractures

Refinements in radionuclide bone imaging in the past decade have provided the clinician with one of the most important diagnostic tools for assessing overuse bone injuries. The triple phase bone scan can be used to determine the location and severity of a stress-induced bony lesion and is particularly indicated in two clinical situations: suspected stress fracture sites that are not readily assessed by physical examination, and high risk stress fractures that, if unrecognized, may lead to longterm disability and morbidity. With the availability of single-photon emission computed tomography, bone scan sensitivity and specificity have improved recently, particularly in stress lesions of the spine. This article reviews the use of radionuclide imaging for clinical diagnosis of overuse bone injuries.