SACRAL INSUFFICIENCY FRACTURES - AN EASILY OVERLOOKED CAUSE OF EACH PAIN IN ELDERLY WOMEN

Sacral insufficiency fractures (SIF) that usually present as nonspecif ic pelvic or low back pain are often overlooked in the elderly. In a r etrospective study conducted in a department of internal medicine, 16 patients with SIF were identified during a 6-year period, All patients were elderly women (mean age of 81 years) who presented with low back or pelvic pain. Radicular pain in rbe lower limb was common. Ten pati ents were bedridden. All 16 patients were osteopenic. Plain radiograph s of the pelvis were nondiagnostic in 11 patients. Radionuclide bone s can showed a typical H-shaped pattern of increased uptake in 11 patien ts, and computed tomographic scan confined SIF (9/9 patients). With be d rest and analgesics, outcome was favorable in all the patients. This study confirms the nonspecific presentation of SIF and the need to ma intain a high index of clinical suspicion to make a prompt diagnosis a nd avoid unnecessary and sometimes invasive procedures.