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Sacral insufficiency fracture.

S P Blake1, A M Connors

  • 1Department of Radiology, South Infirmary-Victoria Hospital, Old Blackrock Road, Cork, Ireland.

The British Journal of Radiology
|October 16, 2004
PubMed
Summary
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Sacral insufficiency fractures, common in elderly women with osteoporosis, are often under-diagnosed. This review highlights imaging features to aid diagnosis of these low back pain causes.

Area of Science:

  • Radiology
  • Orthopedics
  • Geriatrics

Background:

  • Sacral insufficiency fractures are common, particularly in osteoporotic bone.
  • They often result from minimal or unremembered trauma and are frequently bilateral.
  • These fractures are often under-diagnosed, presenting as low back pain.

Purpose of the Study:

  • To highlight sacral insufficiency fractures.
  • To discuss expected imaging features and potential pitfalls.
  • To improve diagnosis and treatment of this condition.

Main Methods:

  • Pictorial review of imaging features.
  • Discussion of diagnostic modalities including plain radiography, MRI, isotope bone scan, and CT.

Main Results:

Related Experiment Videos

  • Plain radiographs are often normal.
  • Lumbar spine MRI can diagnose the condition but may mimic tumors or osteomyelitis.
  • The "H" sign on isotope bone scans is diagnostic but not always present.
  • CT is useful for confirmation and excluding other pathologies.

Conclusions:

  • Clinicians and radiologists must consider sacral insufficiency fractures in the differential diagnosis.
  • Prompt and accurate diagnosis is crucial for appropriate management.
  • Advanced imaging like MRI and CT are essential for diagnosis and ruling out mimics.