{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:22:58Z","timestamp":1789154578960,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the positive rate of early diagnosis and the detection rate of fracture signs in Type I stress fractures using x-ray, CT, and MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 56 patients with Type I stress fractures admitted to the 904st Hospital of the PLA Joint Logistics Support Force from January 2011 to June 2021 were included in the retrospective analysis, including 35 cases of tibial stress fractures (tibia group) and 21 cases of femoral stress fractures (femur group). The positive rate of early diagnosis and the detection rates of visible fracture lines, periosteal reaction, callus formation, surrounding soft tissue swelling, and marrow cavity signal changes were compared between x-ray, CT, and MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:bold>(<\/jats:bold>1) The positive rate of early diagnosis of MRI in the tibia and femur groups were significantly higher than those of x-ray and CT examinations, and the differences were statistically significant (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). (2) In the tibia group, MRI had significantly higher detection rates than x-ray and CT examinations for visible fracture lines, periosteal reaction, surrounding soft tissue swelling, and marrow cavity signal changes, and the differences were statistically significant (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). There was no significant difference in the detection rate of callus formation (<jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05). (3) In the femur group, MRI had significantly higher detection rates than x-ray and CT examinations for visible fracture lines, surrounding soft tissue swelling, and marrow cavity signal changes, and the differences were statistically significant (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). There was no significant difference in the detection rates of periosteal reaction and callus formation (<jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on the definitely diagnostic advantages of MRI for signs such as visible fracture line, surrounding soft tissue swelling, and marrow cavity signal changes, it shows higher accuracy and application value in the early diagnosis of type \u2160 stress fractures.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1333714","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:18:05Z","timestamp":1742195885000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Exploring the early diagnostic value of MRI for type I stress fractures: a retrospective analysis based on imaging manifestations"],"prefix":"10.3389","volume":"12","author":[{"given":"Hui","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cailin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leilei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefeng","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruquan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sen","family":"Guan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e33629","DOI":"10.7759\/cureus.33629","article-title":"Completely displaced femoral neck stress fracture in a young male soldier with almost no functional impact: a case report","volume":"15","author":"Alhawas","year":"2023","journal-title":"Cureus"},{"key":"B2","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1093\/milmed\/usad067","article-title":"Stress fractures in the military: opportunities to advance recognition, treatment, and prevention","volume":"188","author":"Nowak","year":"2023","journal-title":"Mil Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"422","DOI":"10.3390\/ijerph19010422","article-title":"Non-modifiable risk factors for stress fractures in military personnel undergoing training: a systematic review","volume":"19","author":"Lennox","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1055\/s-0041-1739404","article-title":"Triathlete with multiple stress fractures in the lower limbs: case report and literature review","volume":"56","author":"Mendes Junior","year":"2021","journal-title":"Rev Bras Ortop (Sao Paulo)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"68","DOI":"10.31729\/jnma.7268","article-title":"Stress fractures among paramilitary trainee visiting a paramilitary hospital of Nepal: a descriptive cross-sectional study","volume":"60","author":"Shrestha","year":"2022","journal-title":"JNMA J Nepal Med Assoc"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e0216818","DOI":"10.1371\/journal.pone.0216818","article-title":"Effects of anti-pronation shoes on lower limb kinematics and kinetics in female runners with pronated feet: the role of physical fatigue","volume":"14","author":"Jafarnezhadgero","year":"2019","journal-title":"PLoS One"},{"key":"B7","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/j.jsams.2020.11.015","article-title":"Medial tibial stress fracture diagnosis and treatment guidelines","volume":"24","author":"Milgrom","year":"2021","journal-title":"J Sci Med Sport"},{"key":"B8","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1093\/milmed\/usac033","article-title":"Part II: risk factors for stress fractures in female military recruits","volume":"188","author":"Abbott","year":"2023","journal-title":"Mil Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1007\/s00264-023-05739-4","article-title":"Subchondral stress fracture of the femoral head (SSFFH) in young and healthy military recruits: clinical recommendations and fracture configurations on MRI","volume":"47","author":"Yoon","year":"2023","journal-title":"Int Orthop"},{"key":"B10","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1136\/bmjmilitary-2020-001445","article-title":"Distance travelled by military recruits during basic training is a significant risk factor for lower limb overuse injury","volume":"168","author":"Whittle","year":"2022","journal-title":"BMJ Mil Health"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.4085\/1062-6050-0380.19","article-title":"Timing of stress fracture in soldiers during the first 6 career months: a retrospective cohort study","volume":"56","author":"Kardouni","year":"2021","journal-title":"J Athl Train"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2111","DOI":"10.1097\/CORR.0000000000002304","article-title":"Proportion of navy recruits diagnosed with symptomatic stress fractures during training and monetary impact of these injuries","volume":"480","author":"Griffis","year":"2022","journal-title":"Clin Orthop Relat Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1136\/bmjmilitary-2020-001406","article-title":"Diagnosis of stress fractures in military trainees: a large-scale cohort","volume":"168","author":"Shapiro","year":"2022","journal-title":"BMJ Mil Health"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/00913847.2023.2188047","article-title":"Stress fracture of the manubrium sterni during parallel bar dips","volume":"8","author":"Demir Benli","year":"2023","journal-title":"Phys Sportsmed"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e65387","DOI":"10.7759\/cureus.65387","article-title":"Ganglion cyst of the foot causing second and third metatarsal stress reactions and fractures: a case report","volume":"16","author":"Shimozono","year":"2024","journal-title":"Cureus"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e232415","DOI":"10.1148\/radiol.232415","article-title":"Diagnostic accuracy of dual-energy CT for bone stress injury of the lower limb","volume":"313","author":"Foti","year":"2024","journal-title":"Radiology"},{"key":"B17","doi-asserted-by":"publisher","first-page":"53","DOI":"10.63032\/ZFCT7949","article-title":"Ultrasound ability in early diagnosis of metatarsal stress fractures","volume":"3","author":"Silva","year":"2024","journal-title":"ARP Rheumatol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"279","DOI":"10.3390\/app15010279","article-title":"Vibroarthrography as a noninvasive screening method for early diagnosis of knee osteoarthritis: a review of current research","volume":"15","author":"Karpi\u0144ski","year":"2025","journal-title":"Appl Sci"},{"key":"B19","doi-asserted-by":"publisher","first-page":"4102","DOI":"10.3390\/app9194102","article-title":"Comparison of diagnostic accuracy of physical examination and MRI in the most common knee injuries","volume":"9","author":"Krakowski","year":"2019","journal-title":"Appl Sci"},{"key":"B20","doi-asserted-by":"publisher","first-page":"765","DOI":"10.20945\/2359-3997000000562","article-title":"Stress fractures","volume":"66","author":"da Rocha Lemos Costa","year":"2022","journal-title":"Arch Endocrinol Metab"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1735","DOI":"10.1007\/s00247-020-04760-8","article-title":"MRI of tibial stress fractures: relationship between Fredericson classification and time to recovery in pediatric athletes","volume":"50","author":"Ditmars","year":"2020","journal-title":"Pediatr Radiol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e610","DOI":"10.1093\/milmed\/usx238","article-title":"Overuse injuries among female combat warriors in the Israeli defense forces: a cross-sectional study","volume":"183","author":"Schwartz","year":"2018","journal-title":"Mil Med"},{"key":"B23","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1177\/1758573220949992","article-title":"Bone density and its relation to the development of acromial stress fracture following reverse total shoulder arthroplasty","volume":"14","author":"Yeazell","year":"2022","journal-title":"Shoulder Elbow"},{"key":"B24","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s00117-023-01129-4","article-title":"Stressreaktionen und stressfrakturen [stress reactions and stress fractures]","volume":"63","author":"Hackenbroch","year":"2023","journal-title":"Radiologie (Heidelb)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1136\/bmjmilitary-2021-002041","article-title":"Significance of tibial MRI findings of special forces recruits at the onset of their training","volume":"170","author":"Milgrom","year":"2022","journal-title":"BMJ Mil Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"5840925","DOI":"10.1155\/2020\/5840925","article-title":"Metacarpal stress fracture is not an uncommon condition in adolescent racket athletes","volume":"2020","author":"Nishikawa","year":"2020","journal-title":"Case Rep Orthop"},{"key":"B27","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1177\/19417381221109537","article-title":"Retrospective review of radiographic imaging of tibial bony stress injuries in adolescent athletes with positive MRI findings: a comparative study","volume":"15","author":"Nussbaum","year":"2023","journal-title":"Sports Health"},{"key":"B28","doi-asserted-by":"publisher","first-page":"8323","DOI":"10.12998\/wjcc.v10.i23.8323","article-title":"Femoral neck stress fracture and medial tibial stress syndrome following high intensity interval training: a case report and review of literature","volume":"10","author":"Tan","year":"2022","journal-title":"World J Clin Cases"},{"key":"B29","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s12891-019-2532-1","article-title":"Humeral stress fracture in a female CrossFit athlete: a case report","volume":"20","author":"Godoy","year":"2019","journal-title":"BMC Musculoskelet Disord"},{"key":"B30","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1007\/s00117-019-0493-x","article-title":"Stressfrakturen beim sportler als ursache von leistenschmerzen [stress fracture of athletes as a cause of groin pain]","volume":"59","author":"Bath","year":"2019","journal-title":"Radiologe"},{"key":"B31","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1093\/milmed\/usab052","article-title":"Accuracy of the tuning fork test for determination of presence and location of tibial stress fractures in a military training population","volume":"186","author":"May","year":"2021","journal-title":"Mil Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"302","DOI":"10.5435\/JAAOS-D-21-00398","article-title":"Femoral neck stress fractures: an updated review","volume":"30","author":"Bernstein","year":"2022","journal-title":"J Am Acad Orthop Surg"},{"key":"B33","first-page":"10","article-title":"Femoral neck stress fracture","volume":"140","author":"Ziesler","year":"2020","journal-title":"Tidsskr Nor Laegeforen"},{"key":"B34","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1007\/s00132-021-04139-z","article-title":"Stressfrakturen der unteren extremit\u00e4t [stress fractures of the lower limbs]","volume":"50","author":"Harrasser","year":"2021","journal-title":"Orthopade"},{"key":"B35","doi-asserted-by":"publisher","first-page":"e38","DOI":"10.3346\/jkms.2020.35.e38","article-title":"Bone stress injuries in runners: a review for raising interest in stress fractures in Korea","volume":"35","author":"Song","year":"2020","journal-title":"J Korean Med Sci"},{"key":"B36","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.jor.2021.03.019","article-title":"Overview and recommendations for analytical and experimental methodologies for the fatigue fracture of human bones","volume":"25","author":"Boatwright","year":"2021","journal-title":"J Orthop"},{"key":"B37","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.1097\/JSM.0000000000001103","article-title":"Bilateral ischial tuberosity stress fractures in an adolescent football player: a case report","volume":"33","author":"Jones","year":"2023","journal-title":"Clin J Sport Med"},{"key":"B38","doi-asserted-by":"publisher","first-page":"90","DOI":"10.35784\/acs-2024-18","article-title":"Application of EEMD-DFA algorithms and ANN classification for detection of knee osteoarthritis using vibroarthrography","volume":"2","author":"Machrowska","year":"2024","journal-title":"Appl Comput Sci"},{"key":"B39","doi-asserted-by":"publisher","first-page":"19","DOI":"10.12913\/22998624\/189512","article-title":"Application of recurrence quantification analysis in the detection of osteoarthritis of the knee with the use of vibroarthrography","volume":"18","author":"Machrowska","year":"2024","journal-title":"Adv Sci Technol Res J"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1333714\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:18:08Z","timestamp":1742195888000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1333714\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":39,"alternative-id":["10.3389\/fsurg.2025.1333714"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1333714","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]},"article-number":"1333714"}}