Imaging of Sacral Stress and Insufficiency Fractures

Ulrich Josef Albert Spiegl; Klaus John Schnake; Georg Osterhoff; Max J. Scheyerer; Bernhard Ullrich; Philipp Bula; Holger Siekmann

doi:10.1055/a-0640-8933

Zeitschrift für Orthopädie und Unfallchirurgie, Inhaltsverzeichnis

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

Artikel in mehreren Sprachen: English | deutsch

Authors

Ulrich Josef Albert Spiegl

¹Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinik Leipzig
Klaus John Schnake

²Zentrum für Wirbelsäulentherapie, Schön Kliniken, Fürth
Georg Osterhoff

³Klinik für Traumatologie, Universitätsspital Zürich, Zürich, Schweiz
Max J. Scheyerer

⁴Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinik Köln
Bernhard Ullrich

⁵Unfall- und Wiederherstellungschirurgie, BG Klinikum Bergmannstrost Halle
Philipp Bula

⁶Klinik für Unfall- und Wiederherstellungschirurgie, Orthopädie, Plastische-, Hand- und Mikrochirurgie, Städtisches Klinikum Gütersloh gGmbH, Gütersloh
Holger Siekmann

⁷Unfallchirurgie, Universität Halle

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.

Key words

insufficiency fracture - sacrum - stress fracture - MRI - CT

Volltext

Referenzen

References/Literatur
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