Dr Iain Duncan

STRESS FRACTURE GRADING

GRADE XRAY SPECT-CT BONE SCAN MRI
1 normal mild /diffuse increase in tracer uptake.
CT normal
Increased periosteal T2 signal. Normal marrow signal.
2 normal moderately intense tracer uptake, mild sclerosis or thickening, but no fracture line plus changes on STIR and T2 sequences
3 Visible line intense (linear) focal tracer uptake with definite sclerosis or fracture line plus bone marrow signal changes on T1
4 Fracture or periosteal reaction Intense transcortical uptake, cortical disruption, perisoteal thickening Fracture line

*for more information re MRI see here.