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Stress fractures are breaks in bone caused by repeated, prolonged or abnormal stress on a bone. It is not uncommon for elderly patients to develop stress fractures around the knee area. These fractures are easily misdiagnosed. In 16 elderly patients who had 18 stress fractures in the knee area, 13 were misdiagnosed. These 16 cases were analyzed and the findings are reported. All patients had an initial complaint of acute pain in the knee. The one factor that contributed most to misdiagnosis was the presence of another abnormality in the knee, which misled the physician into believing this was the cause of the pain. The character of the knee pain was mechanical, meaning related to activity. In elderly patients, unlike younger patients, the onset of pain rarely followed an unaccustomed activity. The most useful physical sign of this fracture was the point of maximum pain, which corresponded well to the fracture site. Pain relief and fracture healing were achieved by resting and using walking aids, however some patients needed splinting of the leg. Proper diagnosis requires a careful clinical evaluation including X-rays and possibly a bone scan. (Consumer Summary produced by Reliance Medical Information, Inc.)