Stress fractures around the knee in elderly patients. A cause of acute pain in the knee.

A review of the cases of sixteen elderly patients who had eighteen stress fractures around the knee revealed that thirteen fractures had been misdiagnosed, which led to inappropriate management of six. The most frequent factor contributing to misdiagnosis was the presence of other abnormalities of the knee for which the patient had previously consulted the physician. Conservative treatment with rest, walking aids, and, for some patients, splinting of the extremity resulted in relief of pain and healing of the fracture. A careful clinical assessment that includes new radiographs and, if necessary, bone scans is essential for early diagnosis in patients who have acute, incapacitating pain in the knee.