Pelvic stress fracture: assessment and risk factors.
OBJECTIVE
To discuss the case of a patient with a pelvic stress fracture and the differential considerations among patients presenting with hip and/or groin pain.


METHODS
A 42-year-old woman had hip pain after running. Initial radiograph of the pelvis was negative. Subsequent films showed a right inferior pubic ramus stress fracture. Stress fractures of the pelvis are relatively uncommon, accounting for only 1% to 2% of all stress fractures.


RESULTS
Treatment included high-velocity, low-amplitude chiropractic manipulation, ultrasound, and stretching of the psoas and piriformis muscles. After 8 weeks, care was discontinued because the patient's hip pain had resolved. The pelvic fracture was left to heal with time. After 1 year, the patient still had delayed union of the fracture.


CONCLUSIONS
When predisposing factors are present, such as osteoporosis and rheumatoid arthritis, pelvic stress fracture should be suspected in patients with groin or hip-area pain. However, because pelvic stress fractures are relatively rare, radiographic studies are often postponed, making diagnosis difficult.
Lapp
J M
JM
D000328:Adult; D002684:Chiropractic / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D015775:Fractures, Stress / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D020393:Manipulation, Spinal; D017699:Pelvic Pain / Q000209:etiology / Q000628:therapy*; D011630:Pubic Bone / Q000000981:diagnostic imaging / Q000293:injuries*; D011859:Radiography; D011877:Radionuclide Imaging; D012307:Risk Factors; D012420:Running / Q000293:injuries