Imaging pitfalls in fragility fractures of the pelvis: a case series

Fragility fractures of the pelvis are low-energy pelvic ring fractures commonly occurring in older adults. Early diagnosis of fragility fractures of the pelvis is important because of the possibility of fracture progression and deterioration. Herein, we report the imaging characteristics of fragility fractures of the pelvis in three patients that resulted in delayed diagnoses and discuss ways to improve the diagnostic accuracy.

We reviewed the images of three Japanese patients with delayed fragility fractures of the pelvis diagnoses (one male, two females, aged 74-89 years), whose diagnoses were confirmed by orthopedic trauma surgeons after the initial treatments were completed. Their images all showed fractures with minimal displacements, such as those with continuous deformities of the bone cortex, bulging of the bone cortex, and those visible only on multiplanar reconstruction images.

We identified several key imaging features related to the delayed diagnosis of fragility fractures of the pelvis. Emergency physicians should be familiar with the characteristics and imaging features of fragility fractures of the pelvis to prevent delays in their diagnoses.