POSTTRAUMATIC OSTEOLYSIS OF THE PUBIC BONE SIMULATING MALIGNANCY

Posttraumatic osteolysis (PO) of the os pubis is a diagnostic entity c haracterized at radiography by rapidly progressing destructive changes in fractures of the pubic body or rami. Fourteen patients with PO are here reported of whom in 8 the radiographic course of the condition w as followed. They were all post-menopausal women and 7 were predispose d to osteopenia. The primary fractures were related to mild trauma in 7 patients and 7 had insufficiency fractures. Four patients had bilate ral symmetrical PO. All 14 patients had concomitant insufficiency frac tures of the sacrum observed at radiography, CT, scintigraphy or MR, p robably due to pelvic instability caused by the PO of the os pubis. Sy mptoms of the sacral fractures usually dominated the clinical conditio n. Pony healing of the PO did not occur in any of the patients, but in all 8 patients followed radiographically, the fractures of the sacrum healed clinically and at CT. Knowledge about the condition is importa nt to avoid unnecessary biopsy of the PO considered a metastatic lesio n and/or extensive diagnostic search for a primary tumor.