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May 9, 1977

Stress Fractures in Children-Reply

JAMA. 1977;237(19):2038. doi:10.1001/jama.1977.03270460024015

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In Reply.—  The intent of the article was not to proffer one diagnostic technique over another, but to acquaint physicians with an entity that they might have excluded initially in their clinical consideration—that stress fractures can occur in young children.In reviewing the articles mentioned by Dr deR Kolisch, all seem to use radionuclide bone imaging in conjunction with roentgenograms. No one makes the claim that a positive radionuclide scan can differentiate stress fracture, early osteomyelitis, or tumor (primary or metastatic). These scans are useful if these lesions are suspected or if they have been previously diagnosed and are now being observed.I hope that the readers of The Journal will now recognize that stress fractures do occur in young children as well as active young adults and will use whatever diagnostic technique they have available and with which they have experience to arrive at a correct diagnosis.