Purpose: To evaluate the relative involvement of tibial stress injuries using high-resolution axial MR imaging and\r\nthe correlation with MR and radiographic images.\r\nMethods: A total of 33 patients with exercise-induced tibial pain were evaluated. All patients underwent\r\nradiograph and high-resolution axial MR imaging. Radiographs were taken at initial presentation and 4 weeks later.\r\nHigh-resolution MR axial images were obtained using a microscopy surface coil with 60 Ã?â?? 60 mm field of view on a\r\n1.5T MR unit. All images were evaluated for abnormal signals of the periosteum, cortex and bone marrow.\r\nResults: Nineteen patients showed no periosteal reaction at initial and follow-up radiographs. MR imaging showed\r\nabnormal signals in the periosteal tissue and partially abnormal signals in the bone marrow. In 7 patients, periosteal\r\nreaction was not seen at initial radiograph, but was detected at follow-up radiograph. MR imaging showed\r\nabnormal signals in the periosteal tissue and entire bone marrow. Abnormal signals in the cortex were found in 6\r\npatients. The remaining 7 showed periosteal reactions at initial radiograph. MR imaging showed abnormal signals in\r\nthe periosteal tissue in 6 patients. Abnormal signals were seen in the partial and entire bone marrow in 4 and 3\r\npatients, respectively.\r\nConclusions: Bone marrow abnormalities in high-resolution axial MR imaging were related to periosteal reactions\r\nat follow-up radiograph. Bone marrow abnormalities might predict later periosteal reactions, suggesting shin splints\r\nor stress fractures. High-resolution axial MR imaging is useful in early discrimination of tibial stress injuries.
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