title: Postpartum sacral insufficiency fractures.
abstract: Postpartum sacral insufficiency fracture is an uncommon occurrence that is often under-diagnosed because its symptoms of low back, buttock and groin pains may initially be attributed to physiologic biomechanical changes caused by pregnancy or to intervertebral disc disease. We present a case of bilateral sacral insufficiency fractures in a 37-year-old postpartum woman with osteopenic bone mineral density confirmed by dual energy X-ray absorptiometry. The symptoms were initially suspected to be of discogenic cause, and the fractures were incidentally appreciated at the edge of a lumbar spine magnetic resonance image. Therefore, it is important to keep in mind this potential diagnosis when examining imaging studies of postpartum patients. For women who present other risk factors of osteoporosis, imaging of the entire sacrum should be part of the imaging studies. If sacral stress fractures are diagnosed, further evaluation for bone mineral density and underlying metabolic bone disease is recommended.
authors.affiliation: Department of Radiology, McGill University Health Centre, Montreal, QC, Canada. charlesyan@gmail.com.
authors.forename: Charles Xiao Bo
authors.identifier: http://orcid.org/0000-0002-1093-0047
authors.initials: CX
authors.lastname: Yan
authors.affiliation: Division of Endocrinology and Metabolism, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada.
authors.forename: Line
authors.initials: L
authors.lastname: Vautour
authors.affiliation: Department of Radiology, McGill University Health Centre, Montreal, QC, Canada.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Martin
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D015775:Fractures, Stress / Q000000981:diagnostic imaging*; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging / Q000379:methods; D007744:Obstetric Labor Complications / Q000000981:diagnostic imaging*; D049590:Postpartum Period; D011247:Pregnancy; D011644:Puerperal Disorders / Q000000981:diagnostic imaging*; D012447:Sacrum / Q000000981:diagnostic imaging / Q000293:injuries*; D016103:Spinal Fractures / Q000000981:diagnostic imaging*
keywords: Insufficiency fracture; Postpartum low back pain; Pregnancy and lactation related osteoporosis; Sacrum