Utilizing Diagnostic Ultrasound to Diagnose Stress Fractures in High School Athletes: A Critically Appraised Topic
Date
2-19-2025
Faculty Mentor
Christopher Clark, Kinesiology; Jennifer Burgett, Kinesiology
Files
Submission Type
Conference Proceeding
Location
1:30-1:40 pm | Houston Cole Library, 11th Floor
Description
Context: Stress fractures are a common issue in adolescent athletes, particularly those engaged in high-impact sports. Traditional diagnostic tools, such as X-rays, may fail to detect early-stage stress fractures, delaying treatment, and prolonging recovery. Diagnostic ultrasound (US) is a promising non-invasive, real-time imaging tool that offers portability, cost-effectiveness, and dynamic assessment capabilities, making it valuable in sports medicine settings. This critically appraised topic explores the efficacy of diagnostic US in identifying stress fractures in high school athletes and its implications for prognosis and return-to-play timelines.
Methods: A computerized search was completed in October 2024. The search terms used were stress fracture, diagnosis, adolescent, diagnostic ultrasound, manage, athlete, ultrasonography, and bone injury. Electronic databases used were JSU GEM Finder and SPORTDiscus. Inclusion criteria: Studies from the past 10 years written in the English language, that directly examined diagnostic US's role in diagnosing stress fractures in adolescents. Exclusion criteria: adult population, therapeutic ultrasound, and fracture. Validity of the selected studies was determined using the PEDro and QUADAS checklists. One author independently reviewed the studies, scored each paper, and reviewed the completed appraisals to come to a consensus on the study quality.
Results: The literature search retrieved 413 total articles and 408 were excluded based on the inclusion criteria, resulting in five studies. Diagnostic US demonstrated high sensitivity (80%-100%) for detecting stress fractures in the tibia and metatarsals, comparable to MRI in lower extremities. Specificity ranged from 53%-79%. Furthermore, diagnostic US was cost-effective and provided real-time imaging, facilitating quicker return-to-play decisions. However, its accuracy depended heavily on the operator's skill and was less effective for deep bone structures.
Conclusions: Diagnostic US is a valuable tool for athletic trainers and healthcare providers in the early detection of stress fractures in adolescent athletes, especially in resource-limited or sideline settings. While it cannot replace MRI, it can serve as an initial diagnostic step, ruling out injuries and expediting care founded in managing costs and improved accuracy of diagnoses. A multifaceted diagnostic approach combining US and MRI can optimize outcomes, enabling a faster recovery and safer return to play.
Keywords
student research, kinesiology
Rights
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Disciplines
Kinesiology
Recommended Citation
Cole, Jacob, "Utilizing Diagnostic Ultrasound to Diagnose Stress Fractures in High School Athletes: A Critically Appraised Topic" (2025). JSU Student Symposium 2025. 50.
https://digitalcommons.jsu.edu/ce_jsustudentsymp_2025/50
