Postpartum Sacral Stress Fracture

Karataş, Metin; Başaran, Ceyla; Özgül, Esra; Tarhan, Nefise Çağla; Ağıldere, Ahmet Muhteşem

doi:10.1097/phm.0b013e318164a8e6

Cited by 36 publications

(19 citation statements)

References 24 publications

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“…Sacral stress fractures are rare, but they are a more common finding in athletes, such as long-distance runners, who report low back pain [ 1 ]. Sacral stress fractures are common in elderly people affected by osteoporosis or other morbidities such as rheumatoid arthritis, Paget disease, osteogenesis imperfecta, metastasis, and hyperparathyroidism or treated with radiation therapy [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Postpartum Sacral Stress Fracture: An Atypical Case Report

Speziali

Tei

Placella

et al. 2015

Case Reports in Orthopedics

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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.

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Section: Introductionmentioning

confidence: 99%

Postpartum Sacral Stress Fracture: An Atypical Case Report

Speziali

Tei

Placella

et al. 2015

Case Reports in Orthopedics

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“…Because of its subtle clinical and radiologic features, diagnosis is often missed. Patients usually present with low-back, buttock, or pelvic pain-with or without radiating pain to the lower extremity [1,2]. When radicular symptoms do accompany the pain however, it may distract clinicians from the proper diagnosis of sacral fracture.…”

Section: Introductionmentioning

confidence: 99%

“…Fatigue fracture is caused by repetitive stress when a bony structure is intact, whereas insufficiency fracture is caused by a weakened cortical structure under normal stress [1]. …”

Section: Introductionmentioning

confidence: 99%

Postpartum Sacral Stress Fracture Mimicking Lumbar Radiculopathy in a Patient With Pregnancy-Associated Osteoporosis

Park

et al. 2013

Ann Rehabil Med

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Postpartum sacral fracture is relatively rare, and its diagnosis is often delayed. We herein report such a case of a 28-year-old patient who presented with an insidious-onset lower back pain, left buttock pain, and radicular symptoms mimicking lumbar radiculopathy. Laboratory tests showed a decreased 25-hydroxy vitamin D level, and the bone mineral densitometry of both femurs was below the expected range. Plain radiographs of the lumbar spine and pelvis showed no definite abnormality, but lumbosacral spinal magnetic resonance imaging identified a left sacral fracture. Symptoms were alleviated with rest and oral analgesic treatment.

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“…This is difficult in pregnant patients in whom the stress on the fracture is exerted by the fetus. There is some controversy with those supporting early mobilization because weight bearing appears to be necessary to stimulate osteoblastic activity [6,11]. In our case of an intrapartum sacral fracture, pain control was the greater challenge because of the limited therapy options.…”

Section: Discussionmentioning

confidence: 93%

“…To the best of our knowledge, nine cases of postpartum stress fractures have been described. Of these, only six cases have reported the patient's bone density: five presented with normal and one with decreased bone density [11,12]. The incidence of pregnancy-related osteoporosis is approximately 0.4 cases per 100,000 women.…”

Section: Discussionmentioning

confidence: 99%

Low back pain during pregnancy caused by a sacral stress fracture: a case report

Pishnamaz¹,

Sellei²,

Pfeifer³

et al. 2012

J Med Case Reports

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IntroductionSacral stress fractures are a rare but well known cause of low back pain. This type of fracture has also been observed as a postpartum complication. To date, no cases of intrapartum sacral stress fractures have been described in the literature.Case presentationWe report the case of a 26-year-old Caucasian European primigravid patient (30 weeks and two days of gestation) who presented to our outpatient clinic with severe low back pain that had started after a downhill walk 14 days previously. She had no history of trauma. A magnetic resonance imaging scan revealed a non-displaced stress fracture of the right lateral mass of her sacrum. Following her decision to opt for non-operative treatment, our patient received an epidural catheter for pain control. The remaining course of her pregnancy was uneventful and our patient gave birth to a healthy child by normal vaginal delivery.ConclusionsWe conclude that a sacral stress fracture must be considered as a possible cause of low back pain during pregnancy.

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Postpartum Sacral Stress Fracture

Cited by 36 publications

References 24 publications

Postpartum Sacral Stress Fracture: An Atypical Case Report

Postpartum Sacral Stress Fracture: An Atypical Case Report

Postpartum Sacral Stress Fracture Mimicking Lumbar Radiculopathy in a Patient With Pregnancy-Associated Osteoporosis

Low back pain during pregnancy caused by a sacral stress fracture: a case report

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