Sacral insufficiency fracture

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[edit] Discussion

  • 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.
  • Causes

[edit] Imaging Findings

[edit] Plain film

  • Most common finding is a sclerotic band or line.
  • Lytic fracture line or cortical break rarely is observed.

[edit] CT

  • Sacral fractures typically are oriented vertically and located parallel to the sacroiliac joints.
  • Linear fracture line with surrounding sclerosis is observed.

[edit] 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.

[edit] 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.

[edit] Images

Patient #1: Lower back pain. History of pelvic radiation therapy

[edit] See Also

[edit] External Links

[edit] References