title: Sacral insufficiency fracture detected by FDG-PET/CT: report of 2 cases.
abstract: We report 2 cases of sacral insufficient fracture detected by FDG-PET/CT. In case 1, a 79-year-old female patient with malignant lymphoma, who had recent lumbago, received FDG-PET/CT examination. Vertical linear FDG uptake medial to bilateral sacro-iliac joint was observed on FDG-PET and a fracture line corresponding to FDG uptake was observed in bone window of CT images. In case 2, an 81-year-old male patient with colon cancer, who also complained of lumbago, received FDG-PET/CT examination. Vertical linear FDG uptake medial to bilateral sacro-iliac joint and horizontal uptake which connects vertical line (H-shaped) was demonstrated and CT also demonstrated a fracture line corresponding to FDG uptake. H-shaped high intensity area corresponding to FDG uptake was observed on T2-weighted image of MRI. On bone scintigraphy, H-shaped uptake was also observed. Like bone scintigraphy, typical H-shaped FDG uptake may be diagnostic in sacral insufficiency fracture. Adding CT information to FDG-PET, that is, assessing SIF with FDG-PET/CT may be useful when atypical findings are observed.
authors.affiliation: Department of Radiology, Faculty of Medicine, University of Fukui, Yoshida-gun, Japan. tsucchy@fmsrsa.fukui-med.ac.jp
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Tsuchida
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kosaka
authors.forename: Katsuya
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Harumi
authors.initials: H
authors.lastname: Itoh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D005598:Fractures, Spontaneous / Q000175:diagnosis*; D015775:Fractures, Stress / Q000175:diagnosis*; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012447:Sacrum / Q000000981:diagnostic imaging / Q000293:injuries*; D016103:Spinal Fractures / Q000175:diagnosis*; D013382:Subtraction Technique; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18