Hauge M D, Cooper K L, Litin S C
Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL 32224.
Mayo Clin Proc. 1988 Aug;63(8):807-12. doi: 10.1016/s0025-6196(12)62361-1.
Insufficiency fractures of the pelvis, which almost always occur in elderly women with osteoporosis, are often misinterpreted as metastatic disease. The initial symptom of such fractures is severe pain unassociated with an obvious history of trauma. The typical sites of involvement are the sacrum, the iliac bones, and the pubis. The plain film appearance of the sacral and iliac fractures is usually subtle and easily overlooked, and bone scans will show the abnormal areas more readily. The existence of multiple fractures not only in the pelvis but also in the vertebrae and ribs should suggest the diagnosis of insufficiency-type stress fractures. Computed tomography can exclude the presence of a destructive process and an associated soft tissue mass, as would be seen in metastatic disease. If insufficiency fractures are identified in the typical anatomic locations, bone biopsy is unnecessary.
骨盆应力性骨折几乎总是发生在患有骨质疏松症的老年女性中，常被误诊为转移性疾病。此类骨折的初始症状是严重疼痛，且无明显外伤史。典型的受累部位是骶骨、髂骨和耻骨。骶骨和髂骨骨折的X线平片表现通常不明显，容易被忽视，而骨扫描能更轻易地显示出异常区域。不仅在骨盆，而且在椎骨和肋骨出现多处骨折，应提示为应力性骨折。计算机断层扫描可以排除转移性疾病中所见的破坏性病变及相关软组织肿块。如果在典型的解剖部位发现应力性骨折，则无需进行骨活检。
