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Fig. 1. —18-year-old asymptomatic female college distance runner with bilateral grade 1 stress reaction of tibia. Axial T2-weighted fast spin-echo image (TR/TE, 5,000/102) with fat saturation shows periosteal edema (arrows), but tibial bone marrow signal remains normal bilaterally, similar to adjacent subcutaneous fat. Vascular structures may mimic periosteal edema, so it is necessary to evaluate several adjacent images. Periosteal edema was present on 12 contiguous images in this individual, representing cephalo-caudad length of 9.6 cm.