Scintigraphic diagnosis of sacral fractures

Balseiro, J; Ac, Brower; Ziessman, H.A.

doi:10.2214/ajr.148.1.111

Cited by 32 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One of the most sensitive tests to detect these fractures is bone scintigraphy with technetium Tc99-labeled methylene diphosphonate [ 16 ], which has 96% sensitivity and 92% positive predictive value for detecting these fractures. "Honda" or "H" sign in bone scan is diagnostic of SIFs [ 17 ]. Posterior planar images with the sacrum closer to the detector are very sensitive to diagnose these fractures [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Sacral Insufficiency Fractures Mimicking Lumbar Spine Pathology

et al. 2016

View full text Add to dashboard Cite

Sacral insufficiency fractures (SIFs) are a common cause of back pain in the elderly. SIFs mimic the symptoms of lumbar spine pathology and so are commonly missed or underdiagnosed. Here we present four cases of missed SIFs that were subsequently identified and treated. One patient was treated as mechanical lower back ache, another patient underwent root block and two patients underwent surgery for lumbar canal stenosis. None experienced relief of their symptoms after these procedures. Retrospective analysis of X-ray and magnetic resonance imaging data revealed SIFs that were confirmed by computed tomography scans. All four patients were treated for underlying osteoporosis. Two patients who underwent surgery were treated conservatively and other two were treated by sacroplasty involving injection of cement into the fracture. Sacroplasty produced immediate pain relief and early mobilization compared to the conservative group. SIFs should always be considered in the differential diagnosis of an elderly patient presenting with low back symptoms. Sacroplasty can be considered for immediate pain relief and rapid mobilization.

show abstract

Section: Discussionmentioning

confidence: 99%

Sacral Insufficiency Fractures Mimicking Lumbar Spine Pathology

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Therefore, further radiological methods are necessary. The highest sensitivity of 96% offers scintigraphy who shows the typical H-sign (shaped as the car enterprises logo Honda) 6 . On the other hand computertomography with the reduced sensitivity of 50–75% should be combined with the elevated MRI-technology 7 .…”

Section: Introductionmentioning

confidence: 99%

Balloon-assisted sacroplasty as a successful procedure for osteoporotic sacral insufficiency fractures after failure of the conservative treatment

Schwetje

Wahd

Bornemann

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Osteoporotic vertebral fractures without prior adequate traumatization are frequent diagnosed in orthopedics because of the increasing life expectancy and incidence of osteoporosis. The associated high mortality is caused by reduced mobilization which leads to a higher risk of infection and a bedridden state. On the other hand the diagnosis of sacral insufficiency fractures is often prolonged because of unspecific symptoms while being associated with similar risks. This article presents an overview of the present scientific literature and a retrospective analysis of patients treated via balloon-assisted sacroplasty. In 8 years, ten patients (three men and seven women) were treated. The average age was 78.4 years and the average time until the diagnosis 4.6 weeks. In most patients a significant pain reduction after the failure of conservative treatment thanks to operative treatment as well as increased mobility was observed. Only one experienced a minor surgical complication being cement leakage with nerval impaction which did not compromise her clinical outcome or satisfaction with the procedure. Balloon-assisted sacroplasty can possibly be seen as an effective symptomatic therapy in osteoporotic insufficiency fractures.

show abstract

“…The Honda or “H” sign in bone scan was used to diagnose SIFs. [ 35 ] However, SIFs do not always symmetrically involve bilateral alar areas, possibly accounting for different target sites while performing sacroplasty in SIFs. [ 36 ] In this study, we described the methods of reading MR images for SIFs.…”

Section: Discussionmentioning

confidence: 99%

Osteoporotic sacral insufficiency fracture

et al. 2017

View full text Add to dashboard Cite

Sacral insufficiency fractures (SIFs) are easily neglected by clinical physicians.The incidence of SIFs remains unclear in patients with symptomatic osteoporotic compression fractures of the lumbar-sacral area.This retrospective study was conducted by reviewing the medical records and radiological reports and by reading magnetic resonance (MR) images from August 2013 to July 2016. We identified 1233 cases with symptomatic vertebral compression fractures for which surgical interventions were performed. A total of 1144 cases were eligible for this study. Neglected diagnoses by radiologists and clinical physicians were calculated, respectively.The MR imaging (MRI) findings of SIFs were divided into the body (S1, S2, S3, and S4 levels) and alar areas (unilateral, bilateral, transverse, and none).A total of 34 (3.00%) cases with SIFs were identified through MRI. A significant difference was observed between 19 (6.53%) patients aged >80 years and 15 (1.76%) aged <80 years (P < .0001). Eight (23.53%) and 26 (76.47%) cases of SIFs were neglected by radiologists and clinical physicians, respectively. The S2 and S3 levels were the predominantly involved area (23/34; 67.65%). Furthermore, the bilateral alar area was the most commonly involved (19/34; 55.88%), as observed in coronal views of MRI.While treating other levels of osteoporotic compression fractures, radiologists and clinical physicians should be aware of SIFs, particularly when the patients are aged >80 years. The coronal oblique MR images of the thoracolumbar region should be carefully read to avoid neglecting SIFs.

show abstract

Scintigraphic diagnosis of sacral fractures

Cited by 32 publications

References 6 publications

Sacral Insufficiency Fractures Mimicking Lumbar Spine Pathology

Sacral Insufficiency Fractures Mimicking Lumbar Spine Pathology

Balloon-assisted sacroplasty as a successful procedure for osteoporotic sacral insufficiency fractures after failure of the conservative treatment

Osteoporotic sacral insufficiency fracture

Contact Info

Product

Resources

About