[Fatigue fractures of the sacrum in primary biliary liver cirrhosis]

Insufficiency fractures of the sacrum are found in women after radiation therapy of the pelvis and those suffering from postmenopausal and steroid-induced osteoporosis. We report two female patients with insufficiency fractures of the sacrum occurring on the basis of a primary biliary cirrhosis. Both patients had simultaneous Tarlow cysts of the sacrum. The fractures were diagnosed by computed tomography. The findings were sclerotic bone changes, running from the ventral and lateral parts of the lateral mass of the sacrum parallel to the adjacent sacro-iliac joints. These fractures exhibited increased uptake in bone scintigraphy and were responsible for local pain. In one of the patients, the bilateral fractures healed four months after transplantation of the liver was performed.