Patient was escorted from the radiology department to physical therapy for crutch fitting and training. She will treat the hip conservatively for several weeks and have a consultation with orthopedics.
Stress fractures and osteoid osteoma can have very similar radiographic and scintigraphic appearances; in equiviocal cases the two can usually be differentiated with T1-weighted MRI and characteristic features of patient history (e.g. night pain, relieved with asprin). In this case, the patient's occupation as a military recruit, and the worsening of the pain with running, along with the characteristic location of the periosteal reaction on the plain films, clarifies the diagnosis. Treatment for this patient is initially conservative.