07-31-2009, 04:58 PM
A 22-year-old college student comes to see you in the office for the evaluation of right lower leg pain for the last five days. The pain gets worse with exercise and weightbearing, and improves with rest. She is an avid runner, and has been preparing for an upcoming marathon event for the last two months. She says that her shoe has been bothering her a lot recently, especially on the lateral side of the right foot. She denies any other past medical history or history of recent trauma. On physical examination, she has point tenderness with localized swelling over her right lower tibial border. You suspect a distal tibial stress fracture. A plain anteroposterior x-ray film of the right lower leg does not reveal any break in the cortical surface of the bone.
Item 1 of 2
Which of the following is the most appropriate test to confirm the diagnosis?
A. Obtain a PA/lateral film of the right lower leg.
B. Obtain x-rays of both lower extremities for comparison.
C. Repeat the plain x-rays of the right lower extremity after one week.
D. Obtain an ultrasound of her right lower extremity.
E. Obtain a magnetic resonance imaging of her right lower extremity.
Item 1 of 2
Which of the following is the most appropriate test to confirm the diagnosis?
A. Obtain a PA/lateral film of the right lower leg.
B. Obtain x-rays of both lower extremities for comparison.
C. Repeat the plain x-rays of the right lower extremity after one week.
D. Obtain an ultrasound of her right lower extremity.
E. Obtain a magnetic resonance imaging of her right lower extremity.