Sacral insufficiency fractures introduction Sacral insufficiency fractures (SIFs) are often misdiagnosed or under diagnosed and may be the root of back or groin pain.
Sacral insufficiency fractures introduction Sacral insufficiency fractures (SIFs) are often misdiagnosed or under diagnosed and may be the root of back or groin pain. They were orginally described in 1982 and can be a disabloing cause of low back pain and immobilization. Many times the condition can elude diagnostic studies if the sacrum or pelvis is not properly imaged or if there is lack of suspicion by the provider.
The incidence of SIF is estimated to be between 1.0-1.8% but rates as high as 5 % have been reported. Case Vignette A 73 year old female with a history of osteoporosis presents with very mild left groin discomfort and mild right buttocks pain for about one month that seemed to worsen quickly over a few days. She denies any particular trauma to the region.
The pain does seem to be fairly constant throughout the day and worsens with activity. She denies increasing her walking activity or workload recently. There has been very mild relief with ibuprofen and the pain does not seem to wake her up from sleep.
On physical examination, there is tenderness over her right sacroiliac joint and along the sacral ala region superiorly on the right. She had an x-ray of her lumbar spine, pelvis and left hip that showed mild degenerative change over the left hip joint and scattered degenerative changes over the lower lumbar spine, but no definitive fracture. What is the most likely diagnosis?
A) Femoral neck fracture B) Baastrup’s disease C) Sacral insufficiency fracture D) Chronic lumbar compression fracture The sacroiliac joint relieves torsional stress created during normal gait. When pathology is present in the SI joint, mechanical load is transferred more to the sacrum. The sacrum can become weak with age and other conditions such as osteoporosis and can become prone to fracture.
If you are experiencing symptoms that may be related to sacral insufficiency fractures, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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