Module 5: Diagnosing a Bone Stress Injury

Bone stress injury diagnosis focuses on history, symptom behavior, clinical testing, and imaging, with MRI presented as the most useful tool. Typical features include gradual onset over weeks, pain that worsens with activity, localized tenderness, possible swelling, and pain on hopping. Learners are shown how to distinguish bone stress injury from myofascial or tendon-related pain, which is more diffuse and may ease during warm-up. The main imaging options are compared, explaining why X-rays often miss early injury, CT involves higher radiation, and MRI best detects bone edema and helps grade severity. Grading matters because it guides prognosis, with mild injuries healing in weeks and advanced stress fractures taking months. A major emphasis is placed on high-risk sites such as the femoral neck, anterior tibia, navicular, fifth metatarsal, and pars interarticularis. These areas are highlighted because of tension forces, poor blood supply, delayed healing, and risk of serious complications or surgery. The transcript also outlines red flags, differential diagnoses, and the need for early recognition in adolescent athletes, especially those with extension-related low back pain suggestive of pars stress injury.