Z Orthop Unfall 2019; 157(02): 144-153
DOI: 10.1055/a-0640-8933
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Imaging of Sacral Stress and Insufficiency Fractures

Article in several languages: English | deutsch
Ulrich Josef Albert Spiegl
1   Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinik Leipzig
,
Klaus John Schnake
2   Zentrum für Wirbelsäulentherapie, Schön Kliniken, Fürth
,
Georg Osterhoff
3   Klinik für Traumatologie, Universitätsspital Zürich, Zürich, Schweiz
,
Max J. Scheyerer
4   Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinik Köln
,
Bernhard Ullrich
5   Unfall- und Wiederherstellungschirurgie, BG Klinikum Bergmannstrost Halle
,
Philipp Bula
6   Klinik für Unfall- und Wiederherstellungschirurgie, Orthopädie, Plastische-, Hand- und Mikrochirurgie, Städtisches Klinikum Gütersloh gGmbH, Gütersloh
,
Holger Siekmann
7   Unfallchirurgie, Universität Halle
› Author Affiliations
Further Information

Publication History

Publication Date:
27 July 2018 (online)

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Abstract

Fractures of the os sacrum without relevant trauma history are defined as stress or insufficiency fractures and often affect the anterior pelvis. Sacral insufficiency fractures are associated with osteoporosis and occur under physiological load. In contrast, sacral stress fractures are caused by mechanical overloading. Diagnostic confirmation is delayed in many of these patients. Thus, MRI and/or CT should be performed early. Fracture stability should be evaluated by CT. MRI is the better approach to rule out fractures and is highly sensitive. It is indicated in young patients and in patients with non-specific lumbosacral pain. Nuclear imaging techniques are viable alternatives in patients with a contraindication for MRI.