Kaffel Dhia, Ouhiba Amal Ben, Hamdi Wafa, Maatallah Kaouther, Riahi Hend, Bouaziz Mouna Chelly, Ladab Mohamed Fethi, Kchir Mohamed Montacer
Service de Rhumatologie, Institut Mohamed Kassab, Mannouba, Tunisie.
Service de Radiologie, Institut Mohamed Kassab, Mannouba, Tunisie.
Pan Afr Med J. 2018 Aug 7;30:260. doi: 10.11604/pamj.2018.30.260.13452. eCollection 2018.
Post-fracture osteolysis of the sacrum is a rare radiological entity mimicking a serious disease. We report the case of a female patient lost to follow-up after biopsy indication. She presented again after 4 months. During multi-stage bone registration prior to the biopsy, we noticed a change in the appearance of the lesion, associating a linear image (corresponding to the fracture line) with condensation at the edges. Patient's evolution was good after a period of rest at 6-months follow-up. This study highlights the atypical imaging appearance and the diagnostic difficulties associated with post-fracture osteolysis of the sacrum. The particularity of our patient is that symptoms were masked by disc-related nerve root impingement with right L5 root and that the sacrum osteolysis was unexpectedly discovered on CT scan.
骶骨骨折后骨溶解是一种罕见的影像学表现,类似严重疾病。我们报告一例活检指征后失访的女性患者。4个月后她再次就诊。在活检前的多阶段骨成像中,我们注意到病变外观有变化,骨折线呈线性影像,边缘有骨质硬化。6个月随访时,经过一段时间休息,患者病情好转。本研究强调了骶骨骨折后骨溶解的非典型影像学表现及相关诊断困难。我们患者的特殊之处在于症状被L5右侧神经根的椎间盘相关神经根受压所掩盖,骶骨骨溶解意外地在CT扫描中被发现。