Spectrum of skeletal disorders during the peripartum period: MRI patterns

Pregnancy is a normal condition in which a combination of biomechanical and hormonal changes may result in a wide spectrum of skeletal disorders. Skeletal overloading due to postural and weight changes, combined with increased ligamentous laxity stemming from the action of relaxing and the risk of pregnancy-related osteoporosis during childbearing, childbirth, and postpartum, have been associated with various pathologies. Owing to the heterogeneity of proposed contributing factors, skeletal lesions in the peripartum period may be related to different pathogenesis depending on the metabolic status of the patient and the degree of biomechanical stress; thus, a fatigue or insufficiency discrimination is not always easy to make. When combined with clinical data, magnetic resonance imaging (MRI) is a powerful tool in clarifying the cause of skeletal pain in the majority of patients or alerting clinicians to proceed to further investigations. Early detection and tailored treatment are important in order to avoid disease progression and long-term restriction of daily activities which may have an adverse impact on the relationship between the mother and the newborn. This pictorial essay provides an overview of the MRI characteristics and pattern of involvement of skeletal lesions presenting during the peripartum period, combined with demographic data and dual-energy X-ray absorptiometry (DEXA) measurements.