title: Sacral insufficiency fracture after pelvic radiotherapy: a diagnostic challenge for a radiologist.
abstract: Sacral insufficiency fractures can occur as a complication after pelvic radiotherapy. Despite several recent studies showing high incidence of sacral insufficiency fractures in elderly women after pelvic radiotherapy this condition still remains underdiagnosed. We present a case of sudden onset of low back pain in a female patient with a history of cervical cancer radiotherapy. Initial diagnostic imaging misinterpreted SIF for metastasis. Bone scan and single-photon emission-computed tomography with low-dose computed tomography revealed the correct diagnosis. Due to the reasons that sacral insufficiency fractures still remain underdiagnosed this report is important to practical routine work of oncologists and radiologists.
authors.affiliation: Department of Nuclear Medicine, National Cancer Institute, Vilnius University, Vilnius, Lithuania. Electronic address: oksana.lapina@vuoi.lt.
authors.forename: Oksana
authors.initials: O
authors.lastname: Lapina
authors.affiliation: Department of Nuclear Medicine, National Cancer Institute, Vilnius University, Vilnius, Lithuania.
authors.forename: Sigitas
authors.initials: S
authors.lastname: Tiškevičius
mesh_terms: D000368:Aged; D005260:Female; D015775:Fractures, Stress / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D010388:Pelvis; D011832:Radiation Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D012447:Sacrum / Q000000981:diagnostic imaging* / Q000293:injuries / Q000528:radiation effects; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*
keywords: Bone scan; Cervical cancer; SPECT/CT; Sacral insufficiency fracture