title: Postpartum Sacral Stress Fracture: An Atypical Case Report.
abstract: Sacral stress fractures are common in elderly people. However, sacral stress fracture should be always screened in the differential diagnoses of low back pain during the postpartum period. We present a case of sacral fracture in a thirty-six-year-old woman with low back pain and severe right buttock pain two days after cesarean section delivery of a 3.9 Kg baby. The diagnosis was confirmed by MRI and CT scan, while X-ray was unable to detect the fracture. Contribution of mechanical factors during the cesarean section is not a reasonable cause of sacral fracture. Pregnancy and lactation could be risk factors for sacral stress fracture even in atraumatic delivery such as cesarean section. Our patient had no risk factors for osteoporosis except for pregnancy and lactation. Transient or focal osteoporosis is challenging to assess and it cannot be ruled out even if serum test and mineral density are within the normal range.
authors.affiliation: Institute of Orthopedic and Traumatology, "Agostino Gemelli" Hospital, Catholic University, Largo Gemelli 8, 00168 Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Speziali
authors.affiliation: Institute of Orthopedic and Traumatology, "Agostino Gemelli" Hospital, Catholic University, Largo Gemelli 8, 00168 Rome, Italy.
authors.forename: Matteo Maria
authors.initials: MM
authors.lastname: Tei
authors.affiliation: Institute of Orthopedic and Traumatology, "Agostino Gemelli" Hospital, Catholic University, Largo Gemelli 8, 00168 Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Placella
authors.affiliation: Institute of Orthopedic and Traumatology, "Agostino Gemelli" Hospital, Catholic University, Largo Gemelli 8, 00168 Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Chillemi
authors.affiliation: Institute of Orthopedic and Traumatology, "Agostino Gemelli" Hospital, Catholic University, Largo Gemelli 8, 00168 Rome, Italy ; Institute of Translational Research for Musculoskeletal System "Nicola Cerulli", Via Einstein 12, 52100 Arezzo, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Cerulli