Fibula Stress Fracture - MRI features

25 year old badmintom player complaining of pain along the lateral aspect of the left leg:

Axial STIR

Axial T2

                               

Coronal T1

Sagittal T1

Diffuse periosteal thickening is seen along the lateral cortex of the distal fibular shaft with hyperintense signal on T2 and STIR images (arrows) and hyperintense signal of the adjacent intramedullary marrow.

In the midst of the marrow hyperintensity there is a subtle horizontal linear low signal seen best on coronal T1 and sagittal T1 images (arrow) indicative of a fracture line.

There is associated surrounding soft tissue edema.

Appearances  represent a distal fibular stress fracture .

Fibular fractures account for 10% of the stress fractures and are commonly seen in the distal two thirds.