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A 17-year-old collegiate female track runner reports left leg pain for 3 months that was insidious in onset. Radiographs were unremarkable, and an MRI demonstrates increased marrow edema. A bone scan is shown in Figure A. What is the next appropriate step in management?
protected weight-bearing for 4-6 weeks
immediate return to sport
tibia intramedullary nailing
long leg casting
biopsy of the tibial lesion
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A college football player has progressive leg pain for over 6 months, is no longer able to run and has failed all modalities of non-operative treatment. His radiograph shows a linear lucency over the anterior tibia. What is the next most appropriate step to quickly return him to play?
Tibial intramedullary nailing
Posterior tibial plate with bone graft
Bone grafting alone
Protected weight-bearing with crutches
Which of the following stress fracture locations has the greatest likelihood of delayed healing or developing a nonunion?
Anterior cortex of tibia
Posteromedial cortex of tibia
Inferior femoral neck
A 20 year-old distance runner developed proximal tibial pain 6 weeks ago. Initially it was only painful while running, but she now has pain with walking. There is no knee effusion. The radiographs are normal. The MRI is shown. Which of the following is the most appropriate initial management?
Switch to elliptical for lower impact exercise
Prescription anti-inflammatory medicines
Open reduction and internal fixation