We describe the unique case of a supracondylar-supraphyseal femoral stress fracture in a healthy 13-year-old boy. The importance of careful history taking is emphasized particularly in regard to asking about new, repetitive activities. The important differential diagnosis in this anatomical region is neoplastic disease and the use of imaging, particularly MRI scanning will yield useful information but is not definitive. Regular follow-up and repeat imaging must be undertaken where the diagnosis of stress fracture is made so that the diagnosis can be ultimately confirmed with the appearance of a healing fracture. Active management in lower limb stress fractures with immobilization is also emphasized as it is apparent that such fractures often do not follow a benign course. Immobilization will also help ensure compliance to treatment and follow-up, which can sometimes be difficult in this patient population.
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