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Role of Ultrasound in Early Diagnosis of Stress Fracture: A Case Report of Bilateral Distal Fibular Stress Fracture in a Female Recreational Badminton Player

Hak Jun Kim
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Young Hwan Park
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Jae Young Kim
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Gi Won Choi
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A 34-year-old female recreational badminton player presented with left ankle pain 1 week after a recreational badminton game. She reported experiencing a similar pattern of pain in her right ankle 4 months before that had persisted for 3 months. On plain radiography, callus formation was evident on the right distal fibula, and a subtle lesion was observed on the left side. Ultrasound was performed with the clinical suspicion of bilateral, nonsimultaneous, distal fibular stress fracture. Focal hyperechoic thickening of the periosteum with irregularity and hypoechoic periosteal edema over the left distal fibula were identified. These findings were consistent with stress fracture, and an early phase of distal fibular stress fracture was diagnosed. This case report highlights that ultrasound can be an alternative modality to magnetic resonance imaging or bone scan scintigraphy for the early diagnosis of stress fracture.

Korea University Guro Hospital, Seoul, Republic of Korea.

Korea University Ansan Hospital, Ansan, Republic of Korea.

Corresponding author: Hak Jun Kim, MD, PhD, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea. (E-mail: hjunkimos@gmail.com)
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