Many stress fractures can be diagnosed and treated with assurance from the history and clinical findings without x-ray examination or an RBS. In the atypical clinical presentation of stress fractures, we first proceed with conventional x-ray examination to confirm the suspicion of stress fracture. If the findings on x-ray films are normal, only then do we obtain an RBS.We believe the simplest and least expensive workup of stress fractures is the method of choice.An excellent article on the use of RBS to diagnose stress fractures in varsity athletes at the University of Pittsburgh was published after my article was submitted.1 I suggest it for further reading.
Norfray JF. Diagnosis of Stress Fractures-Reply. JAMA. 1980;244(13):1436. doi:10.1001/jama.1980.03310130016013
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