Differential Diagnosis
- Single most likely diagnosis
- Undisplaced Salter-Harris type I fracture of the distal fibula: This diagnosis is the most likely due to the presence of bone marrow edema in the distal fibula, a linear region of low signal extending from the physis distally, and minimal bone marrow edema superior to the physis without physeal plate widening.
- Other Likely diagnoses
- Undisplaced Salter-Harris type II fracture of the distal fibula: Although the physeal plate is not widened, the presence of bone marrow edema superior to the physis could suggest a type II fracture.
- Stress fracture of the distal fibula: The bone marrow edema and linear region of low signal could also be indicative of a stress fracture, particularly if the patient has a history of repetitive stress or overuse.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Osteomyelitis: Although the clinical presentation and imaging findings do not strongly suggest osteomyelitis, it is a potentially serious condition that could present with bone marrow edema and should be considered in the differential diagnosis.
- Pathologic fracture: A fracture through a pre-existing bone lesion, such as a cyst or tumor, could have a similar appearance on imaging and should be considered, especially if the patient has a history of cancer or other underlying condition.
- Rare diagnoses
- Fibular aplasia or hypoplasia: Although rare, congenital conditions affecting the development of the fibula could potentially present with similar imaging findings.
- Infection or inflammation of the distal fibular physis: Conditions such as septic arthritis or inflammatory arthritis could potentially affect the physis and present with similar imaging findings, although these would be rare in the absence of other clinical symptoms.