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.