Which imaging modality will confirm a tibial stress fracture according to the material?

• A. MRI
• B. CT
• C. Plain X-ray
• D. Ultrasound

Answer: (C)

Plain radiographs confirm a tibial stress fracture when the fracture line or healing changes become visible on the film. Stress injuries often aren’t seen early, but as the injury evolves the cortex may show a linear lucency, localized periosteal reaction, or callus formation, which makes the diagnosis radiographically definite. MRI is more sensitive in early stages and can detect stress responses before X-rays change, while CT clarifies cortical disruption and ultrasound isn’t the standard tool for this diagnosis. In the context of this material, once radiographic changes are present, plain X-ray provides the confirming evidence.