How is a stress fracture diagnosed?

Physical examination

During a patient's first visit to the doctor, the doctor will want to have a full understanding of the patient's risk factors for stress fractures. The patient will be asked about his or her medical history, work, activities, and the medications he or she is taking. The doctor will examine the patient's foot and/or ankle. The doctor may then schedule a follow-up appointment for further testing.


A stress fracture can be difficult to see on an X-ray, because the bone often appears normal in the X-ray, and the small cracks can't be seen. X-rays may not help diagnose a stress fracture unless it has started to heal. When the bone starts to heal, it creates a callus, or lump, that can be seen on X-rays. The doctors may recommend a bone scan or magnetic resonance imaging (MRI), which is more sensitive than an X-ray and can spot stress fractures early.

Bone scan

During a bone scan, a tracer (a radioactive substance) is injected into the patient's bloodstream. The tracer collects in the bone and settles in the areas where the bone is being repaired. The area that is affected by a stress fracture will appear darker on the bone scan than an uninjured area.

Magnetic resonance imaging

Magnetic resonance imaging (MRI) is a test that produces very clear pictures, or images, of the human body with a large magnet, radio waves, and a computer to produce these images.

A MRI is preferred in many cases because there is no radiation exposure, it takes less time, and it is better at diagnosing different types of bone and/or soft tissue abnormalities.

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