Sacral Fatigue Fracture in a Female Runner: A Case Report

• Published in: Journal of manipulative and physiological therapeutics Vol. 30; no. 3; pp. 228 - 233
• Main Authors: Haun, Daniel W., DC, Kettner, Norman W., DC, Yochum, Terry R., DC, Green, Richard L., DC
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.03.2007
• Subjects: Adult; Female; Fractures, Stress - diagnostic imaging; Fractures, Stress - etiology; Humans; Low Back Pain - etiology; Low Back Pain - physiopathology; Low Back Pain - therapy; Magnetic Resonance Imaging; Physical Medicine and Rehabilitation; Radiography; Running - injuries; Sacrum - diagnostic imaging; Tomography, Emission-Computed, Single-Photon; Magnetic Resonance Imaging; Fractures; Single-Photon Emission Computed Tomography; Low-Back Pain; Stress; Athletic Injuries
• ISSN: 0161-4754; 1532-6586
• DOI: 10.1016/j.jmpt.2007.01.007

Abstract Objective This case report describes and discusses the clinical presentation, diagnosis, and management of a patient with a sacral fatigue fracture. Clinical Features A 26-year-old female long-distance runner presented with nonspecific low-back and buttock pain that prevented her from training. Intervention and Outcome Radiographic findings on the patient's lumbar spine and pelvis were interpreted as normal. Single-photon emission computed tomography and magnetic resonance imaging were performed, revealing a fatigue fracture of the left sacral ala. The patient discontinued training for 6 months and gradually returned to running. Conclusions A high index of suspicion should prompt investigation with skeletal scintigraphy, computed tomography, or magnetic resonance imaging. Sacral stress fractures may respond well to conservative measures if diagnosed in a timely fashion.