Long, Jeremiah

An understanding of regions of endemicity and the spectrum of organ system involvement can improve recognition of the imaging features of coccidioidomycosis, which can overlap with those of other diseases.

Bone scintigraphy is a valuable adjunct to cross-sectional imaging and can be used to evaluate disease extent in multifocal processes such as blastic osseous metastatic disease, provide diagnostic information to aid in problem solving in challenging cases, and serve as the primary diagnostic modality for diseases that manifest with pathognomonic scintigraphic appearances.

Case: A 25-year-old male pole vaulter presented with several months of right ankle pain. Radiographs showed an anterior tibial osteophyte with a small intra-articular body suggesting impingement. Weight-bearing computed tomography (CT) revealed an associated tibial plafond stress fracture. Subsequent arthroscopy with osteophyte resection and loose body removal significantly improved symptoms, and he gradually resumed training. Conclusion: Stress fractures should always be considered in athletes with ankle pain. A unique aspect of this case was the use of weight-bearing CT in diagnosis and surgical planning. To our knowledge, this is the first described case in which weight-bearing CT was used in this fashion.