Kondo Naoki, Fujisawa Junichi, Arai Katsumitsu, Kakutani Rika, Endo Naoto
Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.
Acta Med Okayama. 2018 Oct;72(5):531-534. doi: 10.18926/AMO/56253.
A 60-year-old Japanese woman with severe osteoporosis presented with a history of right buttock pain and right lateral lower leg pain in an L5 distribution. She had been treated with methotrexate and methylprednisolone for rheumatoid arthritis (RA) and interstitial pneumonia. Computed tomography demonstrated a sacral stress fracture in the right sacral ala. The right L5 nerve root was compressed by the fracture site. This case is rare in that L5 radiculopathy was complicated by a sacral stress fracture. Clinicians should suspect sacral stress fractures when RA or osteoporosis is present in women who experiences lumbar pain and lumbar radiculopathy.
一名60岁患有严重骨质疏松症的日本女性，有右臀部疼痛及L5分布区域的右小腿外侧疼痛病史。她曾因类风湿关节炎（RA）和间质性肺炎接受甲氨蝶呤和甲基泼尼松龙治疗。计算机断层扫描显示右侧骶骨翼存在骶骨应力性骨折。骨折部位压迫右侧L5神经根。该病例罕见之处在于L5神经根病并发骶骨应力性骨折。对于患有腰椎疼痛和腰椎神经根病的女性，若存在RA或骨质疏松症，临床医生应怀疑有骶骨应力性骨折。
