title: Insufficiency fractures of the ilium.
abstract: Insufficiency fractures often occur in the sacrum and pubic rami but have rarely been reported in the ilium, where their frequency may be underestimated. We studied a series of 14 patients with insufficiency fractures of the ilium. Six patients had an oblique fracture through the wing of the ilium (which was bilateral in one case) and nine a supraacetabular fracture, with in one case a superomedial extension into the iliac wing. The initial radiographs were normal, making the diagnosis difficult. A linear area of sclerosis along the fracture line was seen after a few weeks. The radionuclide examination provided early detection and often demonstrated multiple insufficiency fractures (mean 2.1 per patient). Computed tomography missed some of the fractures, whereas magnetic resonance imaging proved a reliable diagnostic tool, especially in patients with supraacetabular fractures, showing the fracture as a line of low signal surrounded by an area of edema whose contours were exactly the same as those of the hyperactive focus on the radionuclide scan. Osteoporosis was a causative factor in all 14 patients and vitamin D deficiency in seven. Also, three patients had a history of fluoride therapy.
authors.affiliation: Rheumatology Department, Nancy Teaching Hospital, France.
authors.forename: I
authors.initials: I
authors.lastname: Chary-Valckenaere
authors.forename: A
authors.initials: A
authors.lastname: Blum
authors.forename: P
authors.initials: P
authors.lastname: Péré
authors.forename: B
authors.initials: B
authors.lastname: Grigon
authors.forename: J
authors.initials: J
authors.lastname: Pourel
authors.forename: A
authors.initials: A
authors.lastname: Gaucher
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D002112:Calcifediol / Q000097:blood; D002118:Calcium / Q000652:urine; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D006801:Humans; D007085:Ilium / Q000000981:diagnostic imaging / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000150:complications / Q000652:urine; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000652:urine
chemical_list: D000469:Alkaline Phosphatase; D002112:Calcifediol; D002118:Calcium