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Unsuspected sacral fractures: detection by radionuclide bone scanning.
AJR. American Journal of Roentgenology
|February 1, 1985
Summary
Unsuspected sacral fractures, often in osteopenic patients with minimal trauma, can be diagnosed using radionuclide bone scans. Recognizing these patterns aids in avoiding misdiagnosis and unnecessary treatments.
Area of Science:
- Radiology
- Nuclear Medicine
- Orthopedic Surgery
Background:
- Sacral fractures are often unsuspected due to confusing clinical, radiographic, and scintigraphic findings.
- Osteopenic patients with minor or no trauma are particularly susceptible to sacral fractures.
Observation:
- Radionuclide bone scans diagnosed sacral fractures in 23 patients, many of whom were osteopenic.
- Symptoms included low back pain and radiculopathy, but some patients were asymptomatic.
- Bone scans showed increased uptake in the sacrum or sacral alae.
Findings:
- Radiographs revealed abnormalities in 11 of 23 patients; CT scans showed abnormalities in all four.
- Original interpretations of radiographs and CT scans were often overlooked or misinterpreted.
- Bone biopsies confirmed reactive bone formation consistent with fracture in two patients.
Implications:
- Characteristic scintigraphic patterns for sacral fractures can prevent misdiagnosis.
- Awareness of sacral fracture frequency in osteopenic individuals is crucial.
- Accurate diagnosis avoids unnecessary tests and treatments.