Abstract
Insufficiency fractures of the sacrum are a commonly recognized form of stress fracture typically occurring in elderly patients. As such patients usually present with low back pain, MR imaging is often performed initially as a means of evaluation. We present 5 patients with sacral insufficiency fractures imaged with MR. Metastatic disease was a leading clinical suspicion as all patients were elderly and three had known primary neoplasms. T1-weighted sequences demonstrated bands of decreased signal intensity, usually paralleling the sacral aspect of the sacroiliac joints and occasionally occurring as a horizontal band across the sacral body. Four of five patients underwent further evaluation with computed tomography (CT) or nuclear bone scanning, which confirmed the diagnosis of sacral insufficiency fracture. We conclude that MRI is sensitive but not specific in detecting sacral insufficiency fractures. As MR imaging is rapidly becoming the method of choice for evaluating back pain, it is important to consider this diagnosis in elderly persons.
Article PDF
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.Avoid common mistakes on your manuscript.
References
Cooper KL, Beabout JW, Swee RG (1985) Insufficiency fractures of the sacrum. Radiology 156:15
Hauge MD, Cooper KL, Litin SC (1988) Insufficiency fractures of the pelvis that simulate metastatic disease. Mayo Clin Proc 63:807
Lee JK, Yao L (1988) Stress fracture: MR imaging. Radiology 169:217
Matin P (1979) The appearance of bone scans following fractures, including immediate and long term studies. J Nucl Med 20:1227
McArdle CB, Crofford MJ, Mirfakhraee M, Amparo EG, Calhoun JS (1986) Surface coil MR of spinal trauma: preliminary experience. AJNR 7:885
Modic MT, Masaryk T, Paushter D (1986) Magnetic resonance imaging of the spine. Radiol Clin North Am 24:229
Rawlings CE, Wilkins RH, Martinez S, Wilkinson RH (1988) Osteoporotic sacral fractures: a clinical study. Neurosurgery 22:72
Schneider R, Yacovone J, Ghelman B (1985) Unsuspected sacral fractures: detection by radionuclide bone scanning. AJR 144:337
Stafford SA, Rosenthal DI, Gebhardt MC, Brady TJ, Scott JA (1986) MRI in stress fracture. AJR 147:553
Vogler JB, Murphy WA (1988) Bone marrow imaging. Radiology 168:679
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Brahme, S.K., Cervilla, V., Vint, V. et al. Magnetic resonance appearance of sacral insufficiency fractures. Skeletal Radiol. 19, 489–493 (1990). https://doi.org/10.1007/BF00202696
Issue Date:
DOI: https://doi.org/10.1007/BF00202696