# Bilateral Medial Tibial Plateau Stress Fractures: A Case Report

## TL;DR

A 43-year-old man with diabetes and a high BMI developed rare bilateral knee stress fractures after increasing his running, diagnosed via MRI and treated conservatively.

## Contribution

Reports a rare case of bilateral medial tibial plateau stress fractures in a middle-aged male with comorbidities.

## Key findings

- MRI was essential for diagnosing stress fractures when initial radiographs were normal.
- Conservative treatment resolved symptoms within three months.
- Risk factors included sudden activity increase, high BMI, and low vitamin D.

## Abstract

Medial tibial plateau stress fractures are rare and often misdiagnosed due to nonspecific symptoms and initially normal radiographs. This case report describes a rare instance of bilateral medial tibial plateau stress fractures in a 43-year-old overweight male police officer with comorbidities including diabetes. The patient developed progressive knee pain after abruptly increasing his running activity. Initial radiographs were inconclusive, but magnetic resonance imaging (MRI) revealed bone marrow edema and non-displaced fractures, highlighting the importance of advanced imaging for early diagnosis. Risk factors included his sudden activity change, high body mass index (BMI), and lower-normal vitamin D levels. Management involved conservative measures like activity modification, weight-bearing as tolerated, and vitamin D supplementation, leading to symptom resolution within three months. The report emphasizes the need for clinical suspicion in middle-aged individuals with persistent knee pain, particularly those with recent activity changes, and underscores MRI's role in early detection. Conservative treatment and patient education on gradual training progression are crucial for recovery and prevention of recurrence.