{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:51:34Z","timestamp":1791366694708,"version":"4.3.1"},"reference-count":59,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Musculoskelet Radiol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The term \u201cstress fracture\u201d encompasses a spectrum of bone injuries resulting from repetitive submaximal loading that exceeds the bone's capacity for repair. This review explores the pathophysiology and clinical classifications of stress-related skeletal injuries, distinguishing between fatigue fractures\u2014occurring when abnormal stress is applied to healthy bone\u2014and insufficiency fractures, which arise from normal physiological stress on weakened bone. I discuss specific manifestations, including spondylolysis, distal clavicular osteolysis, atypical femur fractures, and pregnancy-associated vertebral compression fractures. Furthermore, the role of biomechanical alterations caused by conditions such as scoliosis and lumbosacral transitional vertebra in predisposing bone to stress reactions is addressed. Finally, I overview emerging future directions, specifically zero echo time MRI and deep learning\u2013based synthetic CT, which generate CT-like images from MRI, and deep learning\u2013based opportunistic CT screening for the early detection of osteoporosis, which provides a pathway to prevent catastrophic fracture through automated trabecular attenuation analysis.<\/jats:p>","DOI":"10.1055\/a-2892-9441","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T23:01:42Z","timestamp":1785452502000},"page":"614-628","source":"Crossref","is-referenced-by-count":0,"title":["Stress Reactions in Bone and Stress Fractures"],"prefix":"10.1055","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4325-847X","authenticated-orcid":false,"given":"\u00dcst\u00fcn","family":"Ayd\u0131ng\u00f6z","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine, United States","place":["St. Louis, Missouri"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref1","first-page":"38","volume-title":"Stress fractures","author":"\u00dc Ayd\u0131ng\u00f6z","year":"2019"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1148\/radiol.16142305","article-title":"Acute and stress-related injuries of bone and cartilage: pertinent anatomy, basic biomechanics, and imaging perspective","volume":"280","author":"M N Pathria","year":"2016","journal-title":"Radiology"},{"issue":"04","key":"ref3","first-page":"TC06","article-title":"Study of imaging pattern in bone marrow oedema in MRI in recent knee injuries and its correlation with type of knee injury","volume":"10","author":"K Sahoo","year":"2016","journal-title":"J Clin Diagn Res"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s10140-016-1390-5","article-title":"Stress fractures: pathophysiology, clinical presentation, imaging features, and treatment options","volume":"23","author":"G R Matcuk Jr","year":"2016","journal-title":"Emerg Radiol"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/0021-9290(72)90053-X","article-title":"Mechanical influences in bone remodeling. 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