Evaluation and Management of Stress Fractures of the Pelvis and Sacrum

Hosey, Robert G.; Fernandez, Marifel Mitzi F.; Johnson, Darren L.

doi:10.3928/01477447-20080401-14

Cited by 34 publications

(38 citation statements)

References 19 publications

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“…MRI can be of great value in stress fracture evaluation. Extensive bone marrow edema, depicted as a sizeable intraosseous area of low signal intensity on T1-w and corresponding high signal intensity on T2-w images, surrounding a distinct fracture line, which is of low signal intensity on all MR sequences, is consistent with the diagnosis of a stress fracture in the right clinical context [3–5, 7]. Sacral stress fractures are typically unilateral, involving the superior aspect of the sacral ala and assuming a vertical or oblique orientation, usually parallel to the sacroiliac joints [3, 13, 14].…”

Section: Discussionmentioning

confidence: 88%

“…A gradual return to sports activities after complete symptom resolution is of utmost importance and should be overemphasized to young athletes, as they are eager to engage in strenuous training too early in the recovery phase [2, 5, 10, 12, 19, 27]. Proper conservative treatment, following an early diagnosis, has proved adequate for an effective short-term rehabilitation in the majority of patients [5, 6]. Follow-up imaging and additional rest are indicated in refractory cases [16].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, conventional radiographs are often normal [4] rendering sacral fatigue fractures an underdiagnosed entity [3]. Magnetic resonance imaging (MRI) is indicated when a stress fracture is suspected clinically [5–7]. We present the first case of an amateur soccer player with a sacral fatigue fracture.…”

Section: Introductionmentioning

confidence: 99%

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Sacral Fatigue Fracture in an Amateur Soccer Player

Tzoanos

Tsavalas

Manidakis

et al. 2013

Case Reports in Medicine

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Sacral fatigue fractures represent a frequently overlooked cause of low-back and buttock pain in athletes. A high index of clinical suspicion and MRI utilization can provide the accurate diagnosis. A 38-year-old male amateur, midfielder, soccer player presented to our department with aggravating right buttock pain during the previous month, following an increase in training intensity and frequency on an artificial turf field. A point of maximal tenderness was demonstrated over the area of the right sacroiliac joint. No radiographic abnormalities were observed. MRI of the pelvis revealed the presence of a stress fracture in the right sacral ala. The patient underwent conservative treatment and resumed playing soccer 12 weeks later, with no residual or recurrent clinical complaints. Apart from the recent change in training regimen, decreased shock absorption related to the physical properties of old generation artificial turf may have also been involved in this case.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Sacral Fatigue Fracture in an Amateur Soccer Player

Tzoanos

Tsavalas

Manidakis

et al. 2013

Case Reports in Medicine

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“…The majority of stress fractures occur in the lower extremity with tibia, metatarsals, and fibula being the most commonly reported in the literature [75]. Although the specific etiology of stress fractures is not well delineated, multiple factors, both intrinsic and extrinsic, play a major role in the evolution of stress injuries [76]. Once diagnosed with a stress fracture, nutritional assessment and metabolic work-up including serum vitamin D level should be performed to address the possible factors contributing to the development of the stress fractures.…”

Section: Stress and Insufficiency Fracturesmentioning

confidence: 99%

The Role of Vitamin D in Orthopedic Surgery

2011

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“…21 They represent a spectrum of bone disorders from early injury (stress reaction) up to catastrophic failure of the bone (fracture).…”

Section: Pelvic Stress Injuriesmentioning

confidence: 99%

The Running Athlete

Henning

2014

Sports Health: A Multidisciplinary Approach

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Context:Pelvic stress fractures, osteitis pubis, and snapping hip syndrome account for a portion of the overuse injuries that can occur in the running athlete.Evidence Acquisition:PubMed searches were performed for each entity using the following keywords: snapping hip syndrome, coxa sultans, pelvic stress fracture, and osteitis pubis from 2008 to 2013. Topic reviews, case reports, case series, and randomized trials were included for review.Study Design:Clinical review.Level of Evidence:Level 4.Results:Collectively, 188 articles were identified. Of these, 58 were included in this review.Conclusion:Based on the available evidence, the majority of these overuse injuries can be managed non-operatively. Primary treatment should include removal from offending activity, normalizing regional muscle strength/length imbalances and nutritional deficiencies, and mitigating training errors through proper education of the athlete and training staff.Strength of Recommendation Taxonomy:C

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Evaluation and Management of Stress Fractures of the Pelvis and Sacrum

Abstract: Most stress fractures of the pelvis and sacrum can be treated nonoperatively with activity modification and thorough assessment of training activities and nutritional factors.

Cited by 34 publications

References 19 publications

Sacral Fatigue Fracture in an Amateur Soccer Player

Sacral Fatigue Fracture in an Amateur Soccer Player

The Role of Vitamin D in Orthopedic Surgery

The Running Athlete

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