The document outlines a treatment plan for potential stress fractures over 4 visits spanning 28 days. It involves examining for point tenderness and obtaining radiographs if tenderness persists after 7 or 14 days. If radiographs are positive or the patient has persisting tenderness, a 99mTc bone scan will be done to confirm a stress fracture diagnosis. The document also discusses options for stress fracture screening tests and a therapeutic regimen involving various supplements.

1. Visit 1: Day 1
TMC
Presenting Pain
EXAM:
Point Tenderness
After 7 days
Visit 2: Day 7
Persistent Point
Tenderness?
Return To
Duty
After 14 Days
Visit 3 Day 21?
Persistent Point
Tenderness?
L/AP
Radiographs
After 7 Days
Visit 4 Day 28?
Persistent
Point
Tenderness?
L/AP
Radiographs
Diagnosis
YES
NO
POS
NEG 99T m scan
YES
YES
NO
NO
POS
POS
NEG
NEG
YES
YES
NO
Stress
Fracture
As Is Model

2. Visit 1: Day 1
TMC
Presenting Pain
EXAM:
Point Tenderness
After 7 days
Visit 2: Day 7
Persistent Point
Tenderness?
Return To
Duty
After 14 Days
Visit 3 Day 21?
Persistent Point
Tenderness?
L/AP
Radiographs
After 7 Days
Visit 4 Day 28?
Persistent
Point
Tenderness?
L/AP
Radiographs
Diagnosis
YES
NO
POS
NEG 99T m scan
YES
YES
NO
NO
POS
POS
NEG
NEG
YES
YES
NO
Stress Fracture To Be Model
Fix Forward Early
Where do this?
SF Screen/Test Options
a. Diet questionnaire
b. QUS heel scan
c. Iron 1st screen (TBD)
d. Vit D screen
e. Fitness test
f. Quad-ham muscle imbalance
(see Sportsmetrics)
g. Menstrual Hx
Where issue this?
SF Therapuetic Bar
1. Vit D
2. B vits
3. Calcium citrate
4. EVOO
5. Magnesium
6. Green tea?
7. Plum extract
8. Iron
9. initial Floradix (iron)
bolus?