Lundin B, Björkholm E, Lundell M, Jacobsson H
Department of Diagnostic Radiology, Radiumhemmet Karolinska Hospital, Stockholm, Sweden.
Acta Oncol. 1990;29(2):211-5. doi: 10.3109/02841869009126547.
An entity is described which is characterized by low back pain and increased radionuclide uptake in the sacrum at bone scintigraphy in postmenopausal women having received radiotherapy towards the pelvis because of gynaecological malignancy. The findings stimulate bone metastases, but are in all likelihood caused by insufficiency fractures of the sacrum promoted by bone weakness induced by postmenopausal osteoporosis and radiotherapy combined. The increased radionuclide activity has a characteristic appearance which in the fully developed fracture acquires the shape of an 'H'. In plain radiography, changes are absent or subtle. The proper complementary examination is CT, in which the fractures can be visualized and malignant changes excluded. Awareness of this benign entity is important to avoid overdiagnosis of bone metastases.
描述了一种实体，其特征为患有妇科恶性肿瘤而接受盆腔放疗的绝经后女性出现下背痛，且骨闪烁显像显示骶骨放射性核素摄取增加。这些发现易被误诊为骨转移，但很可能是由绝经后骨质疏松症和放疗联合导致的骨质脆弱所引发的骶骨不全骨折所致。放射性核素活性增加具有特征性表现，在完全形成的骨折中呈“H”形。在X线平片中，无变化或变化不明显。合适的补充检查是CT，在CT中可显示骨折并排除恶性病变。认识到这种良性实体对于避免骨转移的过度诊断很重要。
