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What Does White Small Patches Of Brighter Density In The X Ray Of Tibia Indicate?

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Posted on Tue, 9 Sep 2014
Question: I am trying to understand the healing and pain process of my tibia stress fracture and whether I should be concerned about bone mets. I take Arimidex (no chemo Onco Dx 8) and had a stress fracture of my the medial left tibia. It was confirmed in April via MRI, took about 3 months to feel better, which it did for one month then the pain returned after wearing heals and dancing. I saw a new Orthopedist today for a second opinion and he took a x-ray. He said he feels it is a new stress fracture or more likely knee bursitis, perhaps both. He also reviewed the previous MRI. He said the x-ray did not show a new stress fracture but he showed me (but didn't make a big deal over) a few (2) brighter areas of white patchy density in the area of the stress fracture. He did not explain what they were but acted like it was normal. He wants a MRI and said if it's not a stress fracture he'll give me a cortisone shot for the bursitis. My concern is the white small patches of brighter density in the area of the stress injury. Is this normal? I looked it up and it said it come sometimes resemble bone mets. I have never had any stress injuries before so this whole healing and pain process has me worried. I always have questions that come to me AFTER I leave my appointments. Other than this leg pain returning I feel great! Thank you in advance for your time and advice.
doctor
Answered by Dr. Saurabh Gupta (11 hours later)
Brief Answer:
MRI would help in better diagnosis

Detailed Answer:
Hello,
Thanks for your query.

Stress fracture not present as white small patches of brighter density in the area. It could be some other lesion.

If the lesion is not clear on the x-ray, you can go for a new MRI for better diagnosis.

If you wish you can upload the X-ray picture so that I can help you in better ways.

I do hope that you have found something helpful and I will be glad to answer any further query.

Take care

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Saurabh Gupta (40 minutes later)
Thank you for your response. Let me be more specific, would the healing response process to the original stress fractures from a few months ago show as a white area of brighter density?
doctor
Answered by Dr. Saurabh Gupta (39 minutes later)
Brief Answer:
It can present like this.

Detailed Answer:
Hi,

Thanks for your query again.

Old healed stress fracture ( callus formation ) can present as white area of brighter density.

Hope this helps you.
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Saurabh Gupta

Orthopaedic Surgeon, Joint Replacement

Practicing since :2004

Answered : 5930 Questions

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What Does White Small Patches Of Brighter Density In The X Ray Of Tibia Indicate?

Brief Answer: MRI would help in better diagnosis Detailed Answer: Hello, Thanks for your query. Stress fracture not present as white small patches of brighter density in the area. It could be some other lesion. If the lesion is not clear on the x-ray, you can go for a new MRI for better diagnosis. If you wish you can upload the X-ray picture so that I can help you in better ways. I do hope that you have found something helpful and I will be glad to answer any further query. Take care