Turkish Journal of Physical Medicine and Rehabilitation 2021 , Vol 67 , Num 2

Postpartum stress fracture of bilateral tibia: A case report

Nurbanu Hindioğlu 1 ,Demet Uçar 1 ,Didem Sezgin Özcan 1 ,Tuğrul Örmeci 2
1 Department of Physical Medicine and Rehabilitation, Istanbul Medipol University School of Medicine, Istanbul, Turkey
2 Department of Radiology, Istanbul Medipol University School of Medicine, Istanbul, Turkey
DOI : 10.5606/tftrd.2021.4947 Stress fractures are overuse injuries of the bone characterized by a magnetic resonance imaging (MRI) finding of the fracture line with bone marrow edema. Clinical findings are tenderness and persistent pain. It is usually related to repetitive stresses. A 25-year-old woman was admitted with bilateral severe knee pain. She was in the postpartum period and the complaints started three days after the beginning of 2-h daily walk. The initial plain radiograph showed no abnormality, while MRI demonstrated bilateral incomplete fracture line at the proximal tibia. The patient had accompanying vitamin D deficiency and osteopenia, diagnosed with pregnancy-related osteopenia and stress fracture of bilateral proximal tibia. We advised cessation of weight bearing, resting, and supplementation of calcium and vitamin D. This report highlights that, in the postpartum period, persistent pain may indicate bone lesions such as stress fractures, particularly developing shortly after a vigorous physical activity. Detailed physical examination and further investigations are necessary to detect these fractures and risk factors. Keywords : Postpartum period, stress fracture, tibia