Stress Fractures of the Sacrum

Johnson, Alan W.; Weiss, Carl B.; Stento, Kimberly; Wheeler, Donald L.

doi:10.1177/03635465010290042001

Cited by 87 publications

(14 citation statements)

References 19 publications

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“…Sacral stress fractures are rare injuries among athletes, mainly seen in young female long-distance runners, and are considered to be an uncommon source of low-back pain [9–13]. Stress fractures were initially described in the metatarsals of military recruits after long marches.…”

Section: Discussionmentioning

confidence: 99%

Sacral Fatigue Fracture in an Amateur Soccer Player

Tzoanos

Tsavalas

Manidakis

et al. 2013

Case Reports in Medicine

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Sacral fatigue fractures represent a frequently overlooked cause of low-back and buttock pain in athletes. A high index of clinical suspicion and MRI utilization can provide the accurate diagnosis. A 38-year-old male amateur, midfielder, soccer player presented to our department with aggravating right buttock pain during the previous month, following an increase in training intensity and frequency on an artificial turf field. A point of maximal tenderness was demonstrated over the area of the right sacroiliac joint. No radiographic abnormalities were observed. MRI of the pelvis revealed the presence of a stress fracture in the right sacral ala. The patient underwent conservative treatment and resumed playing soccer 12 weeks later, with no residual or recurrent clinical complaints. Apart from the recent change in training regimen, decreased shock absorption related to the physical properties of old generation artificial turf may have also been involved in this case.

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Section: Discussionmentioning

confidence: 99%

Sacral Fatigue Fracture in an Amateur Soccer Player

Tzoanos

Tsavalas

Manidakis

et al. 2013

Case Reports in Medicine

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“…Three cases involved the tibia, one involved the metatarsal and tibia, and one involved the sacrum [10, 12, 14, 17, 18]. To our knowledge, this case is the first report of a sacral stress fracture after union of a lumbar spondylolysis and we consider it to be a rare pathological condition.…”

Section: Discussionmentioning

confidence: 93%

“…According to Grier et al, suggestive MRI findings of a fatigue fracture were a central lineal signal void on both T1- and T2-weighted sequences surrounded by diffuse low marrow signals on T1 images and increased signals on T2 images [8]. Previous studies that documented a sacral stress fracture reported MRI findings with a lineal low-intensity appearance in the high signal intensity area on T2-weighted sequences [8, 10, 11, 14, 17–20, 22–26]. The MRI findings of this case were compatible based on the radiological findings of previous reports.…”

Section: Discussionmentioning

confidence: 99%

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Sacral Stress Fracture following the Bone Union of Lumbar Spondylolysis

Sasaji

Imaizumi

Takano

et al. 2016

Case Reports in Medicine

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While 22 articles have reported on sacral stress fractures, it is a rare injury and its etiology is not well known. We present the case of a 16-year-old male who presented with low back pain in 2015. He was a high school soccer player with a previous history of a bilateral L5 lumbar spondylolysis in 2014. The patient refrained from soccer and wore a brace for six months. Two months after restarting soccer, he again complained of low back pain. After 1 year, a lumbar spine computed tomography revealed the bone union of the spondylolysis. At his first visit to our hospital, his general and neurological conditions were normal and laboratory data were within the normal range. Sacral coronal magnetic resonance imaging (MRI) of the left sacral ala revealed an oblique lineal signal void surrounding bone marrow edema. Based on his symptoms, sports history, and MRI, he was diagnosed with a sacral stress fracture. He again refrained from soccer; his low back pain soon improved, and, after 1 year, the abnormal signal change had disappeared on sacral MRI. Recurrent low back pain case caused by a sacral stress fracture occurring after the bone union of lumbar spondylolysis is uncommon.

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“…5). Technetium bone scans are very sensitive for stress fractures, but are non specific, a normal bone scan virtually excludes the diagnosis [17]. A bone scan may remain positive for up to 6–9 months after the inciting event in Spondylolysis [18].…”

Section: Bone Scanmentioning

confidence: 99%

What is the role of imaging in acute low back pain?

Lateef

Patel

2009

Curr Rev Musculoskelet Med

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In patients with non specific acute low back pain, without the red flags, a conservative approach is preferable, with assessment in 4–6 weeks. The natural history of low back pain is favorable with improvement over time, thus reassurance to such patients is very important. However, a plain radiograph or more advanced imaging techniques like MRI/CT may be ordered in back pain associated with radiculopathy or spinal stenosis and back pain associated with progressive neurologic deficits. There is limited role of imaging in non specific acute low back pain without the red flags, as the findings correlate poorly with symptoms.

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Stress Fractures of the Sacrum

Cited by 87 publications

References 19 publications

Sacral Fatigue Fracture in an Amateur Soccer Player

Sacral Fatigue Fracture in an Amateur Soccer Player

Sacral Stress Fracture following the Bone Union of Lumbar Spondylolysis

What is the role of imaging in acute low back pain?

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