Sacral insufficiency fracture: Difference between revisions
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New page: right|250px ==Discussion== *Typically, patients present with groin, low back, or buttock pain. *Patients present with either no history of ... |
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== | ==Causes== | ||
* Postmenopausal [[osteoporosis]] (most common) | |||
* Senile osteoporosis | |||
* Pelvic irradiation | |||
* Corticosteroid therapy | |||
* [[Rheumatoid arthritis]] | |||
==Diagnosis== | |||
===History and Symptoms=== | |||
*Typically, patients present with groin, low back, or buttock pain. | *Typically, patients present with groin, low back, or buttock pain. | ||
*Patients present with either no history of trauma or a history of low impact trauma. | *Patients present with either no history of trauma or a history of low impact trauma. | ||
==Diagnostic Findings== | ==Diagnostic Findings== | ||
===Plain | ===Plain Film=== | ||
* The most common finding is a sclerotic band or line. | * The most common finding is a sclerotic band or line. | ||
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==Images== | ==Images== | ||
[http://www.radswiki.net Images courtesy of RadsWiki] | |||
Image:Sacral-insufficiency-fracture-001.jpg | [[Image:Sacral-insufficiency-fracture-001.jpg|left|thumb|400px|Lower back pain. History of pelvic radiation therapy]] | ||
Image:Sacral-insufficiency-fracture-002.jpg | <br clear="left"/> | ||
Image:Sacral-insufficiency-fracture-003.jpg | |||
</ | [[Image:Sacral-insufficiency-fracture-002.jpg|left|thumb|400px|Lower back pain. History of pelvic radiation therapy]] | ||
<br clear="left"/> | |||
[[Image:Sacral-insufficiency-fracture-003.jpg|left|thumb|400px|Lower back pain. History of pelvic radiation therapy]] | |||
<br clear="left"/> | |||
==External Links== | ==External Links== | ||
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==References== | ==References== | ||
{{Reflist|2}} | |||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
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{{WS}} | |||
Latest revision as of 14:28, 8 April 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Causes
- Postmenopausal osteoporosis (most common)
- Senile osteoporosis
- Pelvic irradiation
- Corticosteroid therapy
- Rheumatoid arthritis
Diagnosis
History and Symptoms
- Typically, patients present with groin, low back, or buttock pain.
- Patients present with either no history of trauma or a history of low impact trauma.
Diagnostic Findings
Plain Film
- The most common finding is a sclerotic band or line.
- Lytic fracture line or cortical break rarely is observed.
CT
- Sacral fractures typically are oriented vertically and located parallel to the sacroiliac joints.
- Linear fracture line with surrounding sclerosis is observed.
MRI
- Decreased signal on T1-weighted images and increased signal on T2-weighted images.
- Signal changes are seen as linear bands within the sacral ala and body and are parallel to the sacroiliac joints.
- On T2-weighted images, the fracture line may be seen if it is surrounded by adjacent marrow edema.
Nuclear Medicine
- H or "Honda sign" which indicated horizontal involvement of the sacrum and vertical involvement of the sacral ala
- The "dot and dash" pattern is another common appearance.
Images
