Sacroiliitis or insufficiency fracture?

Sacral stress fracture and sacroiliitis are two conditions that present with pain. Sacral stress fractures are a rare cause of lumbar and hip pain. Sacral insufficiency fractures are a type of sacral stress fractures. Sacroiliitis represents inflammation of the sacroiliac joints. Coexistence of sacr...

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Bibliographic Details
Published in:Osteoporosis international 2016-03, Vol.27 (3), p.1265-1268
Main Authors: Memetoğlu, O. G., Ozkan, F. U., Boy, N. S., Aktas, I., Kulcu, D. G., Taraktas, A.
Format: Article
Language:English
Subjects:
Adult
Calcium
Case Report
Chronic Disease
Diagnosis, Differential
Endocrinology
Female
Fractures
Fractures, Stress - complications
Fractures, Stress - diagnostic imaging
Hip joint
Humans
Magnetic Resonance Imaging - methods
Medicine
Medicine & Public Health
Orthopedics
Pain
Pain - etiology
Rheumatology
Sacroiliitis - complications
Sacroiliitis - diagnostic imaging
Sacrum - diagnostic imaging
Sacrum - injuries
Vitamin D
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Summary:Sacral stress fracture and sacroiliitis are two conditions that present with pain. Sacral stress fractures are a rare cause of lumbar and hip pain. Sacral insufficiency fractures are a type of sacral stress fractures. Sacroiliitis represents inflammation of the sacroiliac joints. Coexistence of sacroiliitis and sacral insufficiency fracture (SIF) has not been reported before. Case 1: A 39-year-old woman reporting inflammatory back pain. Imaging revealed bilateral chronic sacroiliitis and bilateral SIF. Case 2: A 31-year-old woman presenting with left hip and inguinal pain. Imaging revealed left sacroiliitis and ipsilateral SIF. Calcium and vitamin D supplementation together with nonsteroidal anti-inflammatory drug (NSAID) treatment were given. Sulfasalazine was added to the treatment of the second patient who developed peripheral arthritis during follow-ups. Early diagnosis is best made with magnetic resonance imaging (MRI) since roentgenograms may be negative initially. Furthermore, MRI findings of both entities share common features leading to a diagnostic dilemma. Interpretation of radiological findings assisted by detailed history and clinical findings is crucial for diagnosis and treatment.
ISSN:0937-941X
1433-2965
DOI:10.1007/s00198-015-3363-z