{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:02:42Z","timestamp":1790420562411,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the sensitivity and specificity of ultrasound imaging (USI) compared to the reference\u2010standard of MRI in the diagnosis of bone stress injury (BSI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective blinded cohort study was conducted. Thirty seven patients who presented to an academic sports medicine clinic from 2016 to 2020 with suspected lower\u2010extremity BSI on clinical exam underwent both magnetic resonance imaging (MRI) and USI. Participant characteristics were collected including age, gender and sport. Exclusion criteria included contraindication for dedicated MRI, traumatic fracture, or severe tendon or ligamentous injury. The primary outcome measure was BSI diagnosis by USI. An 8\u2010point assessment system was utilized on USI for diagnosis of BSI, and the Fredericson and Nattiv<jats:sup>22<\/jats:sup> criteria were applied to classify MRI findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty seven participants who met study criteria were consented to participate. All participants completed baseline measures. Using MRI, there were 30 (81%) athletes with a positive and seven participants with a negative BSI diagnosis. The most common BSIs in the study were in the metatarsal (54%) and tibia (32%). Compared to MRI, USI demonstrated 0.80 sensitivity (95% confidence interval [CI], 0.61\u20130.92) and 0.71 specificity (95% CI, 0.29\u20130.96) in detecting BSI, with a positive predictive value of 0.92 (95% CI, 0.75\u20130.99) and negative predictive value of 0.45 (95% CI, 0.17\u20130.77).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>USI is a potentially useful point\u2010of\u2010care tool for practicing sports medicine providers to combine with their clinical evaluation in the diagnosis of BSIs. Further research is ongoing to determine the role of USI in follow\u2010up care and return\u2010to\u2010play protocols.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.15977","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T13:49:42Z","timestamp":1647956982000},"page":"2885-2896","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of Ultrasonography to <scp>MRI<\/scp> in the Diagnosis of Lower Extremity Bone Stress Injuries"],"prefix":"10.1002","volume":"41","author":[{"given":"Isaac","family":"Syrop","sequence":"first","affiliation":[{"name":"Department of Rehabilitation and Regenerative Medicine Columbia University Vagelos College of Physicians and Surgeons  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaeko","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Kansai Medical University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Mullins","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation UC Davis  Davis CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Raiser","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Emory University  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Lawley","sequence":"additional","affiliation":[{"name":"Sports Medicine Orthopedic Centers of Colorado  Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Bosshardt","sequence":"additional","affiliation":[{"name":"Emergency Medicine Prisma Health Upstate  Greenville SC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Finlay","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Division of Physical Medicine and Rehabilitation Stanford University School of Medicine  Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah","family":"Ray","sequence":"additional","affiliation":[{"name":"Hoag Medical Group, Foothill Ranch  CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fredericson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Division of Physical Medicine and Rehabilitation Stanford University School of Medicine  Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/RMR.0b013e3180421c8c"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1249\/01.mss.0000227543.51293.9d"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513520295"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2011.34"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v8.i3.242"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v2.il.7"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3810\/psm.2014.11.2095"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354657500300502"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354658701500107"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14588"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2020.35.e38"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2015.08.008"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-006-0272-4"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-016-1390-5"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2005.08.009"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.3928\/0147-7447-19930101-12"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/02841859809172456"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3413\/Nukmed-0448-11-12"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-5919(05)70023-5"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354659502300418"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-5919(05)70023-5"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513490645"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.6826"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.159.6.1442422"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.173.6.10584808"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0096(200001)28:1<20::AID-JCU3>3.0.CO;2-W"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2003.22.2.145"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-004-2525-8"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080657"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14276"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1142\/S0218957708001997"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515574066"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.20577"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.046979"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kjms.2015.11.004"},{"key":"e_1_2_6_37_1","first-page":"1050","article-title":"Distal fibular stress fracture in a female recreational runner: a case report with musculoskeletal ultrasound imaging findings","volume":"10","author":"Hoglund LT","year":"2015","journal-title":"Int J Sports Phys Ther"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jus.2011.09.002"},{"key":"e_1_2_6_39_1","unstructured":"Mark Stevenson with contributions fromTelmoNunes CordHeuer JonathonMarshall JavierSanchez RonThornton JenoReiczigel JimRobison\u2010Cox PaolaSebastiani PeterSolymos KazukiYoshida GeoffJones SarahPirikahu SimonFirestone RyanKyle JohannPopp MathewJayandCharlesReynard. (2020).epiR: Tools for the Analysis of Epidemiological Data. R package version 1.0\u201014.https:\/\/CRAN.R-project.org\/package=epiR."},{"key":"e_1_2_6_40_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2020"},{"key":"e_1_2_6_41_1","volume-title":"RStudio: Integrated Development for R","author":"RStudio Team","year":"2019"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354659502300418"},{"key":"e_1_2_6_43_1","first-page":"297","article-title":"Stress fractures in the lower extremities of soldiers in basic training","volume":"21","author":"Pester S","year":"1992","journal-title":"Orthop Rev"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rx.2017.07.004"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.01593"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0096(200001)28:1<20::AID-JCU3>3.0.CO;2-W"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.2057"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/TME.0000000000000154"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097037"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2011.09.006"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00117-015-0003-8"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-013-0306-2"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.15977","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jum.15977","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.15977","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T22:22:16Z","timestamp":1692656536000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.15977"}},"subtitle":["A Prospective Cohort Study"],"short-title":[],"issued":{"date-parts":[[2022,3,22]]},"references-count":51,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1002\/jum.15977"],"URL":"https:\/\/doi.org\/10.1002\/jum.15977","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,22]]},"assertion":[{"value":"2021-02-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}