PMC5514337_01
The anteroposterior radiograph of right knee at the onset showing no abnormal finding.
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Radiograph of the right knee showed no obvious findings of fracture but the appearance of bone atrophy in the proximal tibia (Figure 1).
(a) Coronal CT imaging of right knee shows irregularity of cortex in the proximal medial tibia (yellow arrow) with trabecular bone resorption in the central part of the proximal tibia (yellow arrow heads), which indicates osteomalacia. (b) Coronal T1 weighted MR imaging of right knee shows linear low intensity lesion at the proximal medial tibia (yellow arrow), which indicates insufficiency fracture.
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In computed tomography (CT) imaging of right knee, trabecular bone structure in the central part of the proximal tibia apparently was resorbed, which indicated osteomalacia, and medial cortex of the tibia was partly irregular (Figure 2(a)). Magnetic resonance (MR) imaging could reveal the fracture line of right medial proximal tibia (Figure 2(b)).
The anteroposterior radiograph of right knee 4 months after the onset showing the bone union of the insufficiency fracture (yellow arrow).
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Six months after the onset, she could walk without right knee pain, and radiographically the fragile fracture was united (Figure 3).