Sports Medicine

, Volume 4, Issue 1, pp 65–75 | Cite as

Scintigraphic Uptake of 99mTc at Non-Painful Sites in Athletes with Stress Fractures

The Concept of Bone Strain
  • G. O. Matheson
  • D. B. Clement
  • D. C. McKenzie
  • J. E. Taunton
  • D. R. Lloyd-Smith
  • J. G. Macintyre
Injury Clinic


Stress fractures are commonly found in athletes attending sports medicine clinics for diagnosis of lower limb pain. Plain radiographs are less reliable than the 99mTc bone scan for diagnosing stress fractures because of their low sensitivity. While the heightened sensitivity of the bone scan is advantageous as a diagnostic aid, the uptake of99mTc at non-painful sites occurs frequently in the athlete. Although the clinical significance has not been determined, asymptomatic uptake may indicate bone remodelling as part of a continuum of adaptation to physical stress. It is not known whether athletes who have uptake of99mTc in asymptomatic areas represent a separate population from those who do not. This study retrospectively reviewed the medical charts and bone scan reports of 320 athletes diagnosed as having stress fractures, to determine the frequency of asymptomatic focal uptake at sites other than the site of pain. This group was compared with the group who had no asymptomatic uptake on a number of demographic variables and physical findings. Asymptomatic focal uptake was found in 37.5% of athletes with the average number of sites being 1.8 per person. No significant differences between groups with focal asymptomatic uptake and groups with no asymptomatic uptake were found when compared4 for age, height, weight, mileage in runners, times to diagnosis and recovery, frequency of tenderness, swelling, trauma history, varus alignment, and x-ray abnormalities. It is concluded that asymptomatic uptake of99mTc occurs frequently in athletes with stress fractures and there are no significant clinical differences between the group with asymptomatic uptake and the group without. It is suggested that symptomatic uptake of99mTc represents the remodelling response of bone to physical stress.


Stress Fracture Endurance Limit Overuse Injury Focal Uptake Varus Alignment 
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Copyright information

© Adis Press Limited 1987

Authors and Affiliations

  • G. O. Matheson
    • 1
  • D. B. Clement
    • 1
  • D. C. McKenzie
    • 1
  • J. E. Taunton
    • 1
  • D. R. Lloyd-Smith
    • 1
  • J. G. Macintyre
    • 1
  1. 1.Division of Sports Medicine, Department of Family Practice and the British Columbia Sports Medicine ClinicUniversity of British ColumbiaVancouverCanada

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