- insufficiency frxs of sacrum and pelvis may be confused w/ metastatic lesions, especially if bony resorption occurs at frx ends;
- these injuries may also occur in patients with known malignant disease who have a sudden onset of pain in the lower back, hip, or groin;
- they may occur with normal activities such as walking;
- Bone Scan:
- useful in patients with insufficiency fractures;
- look for vertical increase in uptake of radionuclide;
- w/ bilateral fractures, an H-shaped distribution ("Honda sign");
- pts who have these patterns should have follow-up CT scans through sacrum in order to confirm the diagnosis;
- complete healing may take upto 9 months;
- patients require protected wt bearing in order to avoid late displacement and possible malunion;
- patient also need to be protected from sacral decubiti
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Transverse fractures of the sacrum. A report of six cases.
Conservative management of transverse fractures of the sacrum with neurological features. A report of four cases.
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Sacral insufficiency fractures: an often unsuspected cause of low back pain.
Insufficiency fractures of the sacrum.
Magnetic resonance appearance of sacral insufficiency fractures.
Spontaneous osteoporotic fracture of the sacrum: an unrecognized syndrome of the elderly.
Unsuspected sacral fractures: detection by radionuclide bone scanning.
Detection of osteoporotic sacral fractures with radionuclides.