Suspected stress fracture

Xray is a required first step before consideration of other imaging. If findings conclusive, no additional imaging generally needed. The next step can include repeat x-ray, bone scan, MRI or CT. Repeat xray if planned conservative management.

Bone scan very sensitive next test (95% detection of fracture at 72 hours post injury). Can be non-specific though. CT can then be used for sacrum. MRI best elsewhere given its specificity and sensitivity.