What is the role of ultrasonography in the workup of metatarsal stress fractures?

Updated: Jan 16, 2019
  • Author: Valerie E Cothran, MD; Chief Editor: Craig C Young, MD  more...
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In a case-control study, Banal et al evaluated the sensitivity and specificity of ultrasonography to detect early stress fractures as an alternative imaging modality to MRI and bone scan scintigraphy, which are expensive or invasive, time-consuming, and poorly accessible. [21] The investigators analyzed 41 feet from 37 patients with ultrasonography and dedicated MRI. MRI detected 13 fractures in 12 patients. Ultrasonography sensitivity was 83%; specificity, 76%; positive predictive value, 59%; and negative predictive value, 92%. [21] These findings led Banal et al to conclude that when radiographs are normal, ultrasonography should be used in the diagnosis of metatarsal bone stress fractures due to its low cost, noninvasiveness, rapidity, and easy technique with good sensitivity and specificity.

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