Sacral osteoblastoma masquerading as sacroiliac joint dysfunction: A case report

Area of Science:

• Orthopedics
• Neurosurgery
• Radiology

Background:

• Lumbosacral pain is frequently mechanical, but rare tumors like osteoblastoma can present similarly, causing diagnostic delays.
• An 18-year-old male with persistent right-sided lumbosacral pain initially diagnosed with sacroiliac joint dysfunction did not improve with conservative care.

Purpose of the Study:

• To highlight the importance of considering red flags in persistent back pain.
• To illustrate a case of osteoblastoma mimicking benign spinal pain.

Main Methods:

• A case presentation of an 18-year-old male with recalcitrant lumbosacral pain.
• Diagnostic workup included magnetic resonance imaging (MRI), computed tomography (CT), and CT-guided biopsy.
• Surgical excision of the sacral tumor with nerve root decompression was performed.

Main Results:

• Imaging revealed a sacral osteoblastoma with aneurysmal bone cyst features.
• Surgical intervention was successful, with no recurrence at 1-year follow-up.
• The patient achieved symptom resolution and returned to pre-morbid function.

Conclusions:

• A poor response to conservative management for lumbosacral pain should prompt further investigation with imaging.
• Considering rare diagnoses like osteoblastoma is crucial when standard treatments fail.