X-ray diagnosis of stress fracture of the pubic ramus / 中华放射学杂志

ABSTRACT

Objective To study the X-ray findings and evaluate the value of X-ray in diagnosis of stress fracture of the pubic ramus. Methods The X-ray findings of 66 cases (18 males and 48 females, ranging in age from 18-21 years, mean age 19.6 years) with stress fracture of the pubic ramus were retrospectively analyzed. Fifty-five cases were military recruits undergoing basic training, and 11 army veterans were undergoing intensive goose step training. Results Sixty-two cases had stress fractures of the inferior pubic ramus including right-sided in 26, left-sided in 30, and bilateral in 6. Four had ipsilateral inferior and superior pubic rami fractures. With 2 weeks after onset, the radiographs were normal in 3 cases. The 66 cases had either a slight transverse fissure (34 cases) or a small dense callus (65 cases) or both during the examination period of 4 weeks to 8 months. Then the calcium resorbed at the margins of the fracture and at the same time the callus increased and surrounded the bone. Finally, the resorptive zone disappeared and the callus became homogeneous. This callus formation persisted for several months and disappeared gradually. Conclusion X-ray examination is the first imaging method of choice for detecting stress fracture of the pubic ramus. With combining clinical data, correct diagnosis can be made in the majority.