Stress fractures of the sacrum and lower extremity

Stress fractures of the lower extremity and sacrum occur in a variety of patients, ranging from young, healthy athletes to elderly persons with underlying illnesses. Knowledge of the activities and risk factors associated with these fractures may heighten clinical suspicion and help direct an appropriate evaluation. Diagnosis is usually based on characteristic features of the history and physical examination accompanied by radiologic findings. Bone scintigraphy remains the standard, but the specificity of computed tomography scanning or magnetic resonance imaging may be required to differentiate stress fractures from other processes such as malignant bone lesions. Management of stress fractures is usually conservative, with variation depending on fracture location and patient characteristics.