Peh W C, Khong P L, Yin Y, Ho W Y, Evans N S, Gilula L A, Yeung H W, Davies A M
Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Radiographics. 1996 Mar;16(2):335-48. doi: 10.1148/radiographics.16.2.8966291.
Insufficiency fractures of the pelvis are being increasingly recognized as a major cause of low back pain in elderly women with osteoporosis. Fractures in the sacrum are difficult to diagnose, as plain radiographic findings are either unhelpful or misleading. Bone scintigraphy is very sensitive for the detection of fractures in the sacrum, with demonstration of the H-shaped (or butterfly) sacral pattern or the combination of concomitant sacral and parasymphyseal uptake being considered as characteristic of insufficiency fractures. Computed tomography (CT) is helpful for confirming the presence of fractures in cases with atypical scintigraphic patterns, particularly in those with a known primary malignant neoplasm. CT is especially useful in the further evaluation of parasymphyseal and pubic rami lesions. The majority of patients respond well to periods of enforced bed rest and administration of analgesics. Recognition of the spectrum of imaging findings for this entity should lead to its correct identification and the institution of appropriate treatment.
骨盆应力性骨折正日益被视为骨质疏松老年女性下背痛的主要原因。骶骨骨折难以诊断，因为普通X线片检查结果要么无帮助，要么具有误导性。骨闪烁扫描对骶骨骨折的检测非常敏感，显示H形（或蝶形）骶骨模式或骶骨与耻骨联合旁摄取同时出现被认为是应力性骨折的特征。计算机断层扫描（CT）有助于在闪烁扫描模式不典型的病例中确认骨折的存在，特别是在那些已知有原发性恶性肿瘤的病例中。CT在耻骨联合旁和耻骨支病变的进一步评估中特别有用。大多数患者通过强制卧床休息和服用镇痛药能取得良好疗效。认识到该疾病的影像学表现范围应能导致其得到正确识别并采取适当治疗措施。
