(1) To provide a brief overview ofpelvic and sacral bony anatomy. (2) To review imaging findings of sacral and pelvic insufficiency fractures (ISF) and aassociated complications. (3) Review potential pitfalls in imaging interpretation to prevent unnecessary work-up oradverse patient outcomes. (4) Review cases to reinforce teaching points.
The incidence of sacral and pelvic ISFs is increasing due to rapidly aging populations.
ISFs area significant cause of functional disability in the elderly .
They are a result of normal stresses on abnormal bone which are largely a result of osteoporosis.
Patientsmay present with chronic lower back,
pelvic or groin pain with (usually minor) or without trauma [2,3].
Other risk factors include prior radiotherapy to the pelvis (e.g.
for sacral chordomas or cervical cancer),
Imaging findings OR Procedure Details
OSSEOUS ANATOMY The sacropelvic structural stability is conferred bythe sacrum and bilateral innominate bones,
andligaments thatcollectivelyform the pelvic ring's osteo-ligamentous complex .
The sacrum is a triangular bone in the lower part of the vertebral column.
It articulates with the last lumbar vertebra (typically L5) and coccyx,
at its base and apex,
it articulates with the iliac bones on either side,
forming the sacroiliac joints.
there are the...
In this pictorial,
we reviewed the anatomy and pathological features of pelvic and sacral insufficiency fractures,
including important diagnostic imaging characteristicsas well asinjuries that are related to these fractures.
we highlighted several imaging pearls and potentialpitfalls and used few case illustrations to reinforce these teaching points.
and consequently ISFs,
become increasingly importantin terms of social and economic significance in aging...
(1) Taillandier J,
Mortality and functional outcomes of pelvic insufficiency fractures in older patients.
Joint Bone Spine 2003; 70:287–289. (2) Kiuru MJ,
Fatigue stress injuries of the pelvic bones and proximal femur: evaluation with MR imaging.
European Radiology 2003; 13:605-611. (3)Schindler,
Sacral insufficiency fractures.
Journal of Orthopaedic Surgery 2007;15(3):339-46. (4)Cabarrus MC,