Diagnosis

Doctors can sometimes diagnose a stress fracture from a medical history and a physical exam, but imaging tests are often needed.

• X-rays. Stress fractures often can't be seen on regular X-rays taken shortly after your pain begins. It can take several weeks — and sometimes longer than a month — for evidence of stress fractures to show on X-rays.
• Bone scan. A few hours before a bone scan, you'll receive a small dose of radioactive material through an intravenous line. The radioactive substance is heavily absorbed by areas where bones are being repaired — showing up on the scan image as a bright white spot. However, many types of bone problems look alike on bone scans, so the test isn't specific for stress fractures.
• Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to create detailed images of your bones and soft tissues. An MRI is considered the best way to diagnose stress fractures. It can visualize lower grade stress injuries (stress reactions) before an X-ray shows changes. This type of test is also better able to distinguish between stress fractures and soft tissue injuries.