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Sports Medicine

Stress Fracture or Bone Bruise?

10/17/2011

Question:

About four weeks ago during our football game i caught the ball and got hit up high and right after i planted my left leg, trying to stay up as the kid held on to me, he lost his grip on me and sat on the outside of my leg and i felt the pain immediately. I kept playing through the game, of course, but the doctors told me its either a stress fracture or a bone bruise of my fibula because x rays were negative. When i walk its fine, but when i run it hurts locally in one spot, also when i squat down and stay squatted on my bad leg it doesnt hurt but when i relax after squatting it hurts a lot a feels like a LOT of pressure in the one spot. Just wandering which its more likely to be?

Answer:

From your description, it sounds like your leg pain has resulted from this player sitting on your outer leg - rather than injury resulting from the hit itself.

The fact you were able to continue playing afterwards would make a significant "internal derangement" (ACL injury, fracture) of your knee unlikely.

A stress fracture results from repetitive microtrauma and overuse, so this would not be the correct term to apply to your condition.

You may have sustained a contusion (bruise) to your fibula and/or the surrounding soft tissue, there may have been a small acute fracture not clearly evident on initial X-rays, or, alternatively, you could have sustained injury (sprain) to the proximal tibiofibular joint, which would then be tender to palpation, and your pain symptoms would be reproduced by stressing this joint during physical examination.

A follow-up evaluation by your physician should help sort this out, but if necessary, an MRI scan could clarify your diagnosis - if MRI results would change treatment.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University