The Sacrum: Pathologic Spectrum, Multimodality Imaging, and Subspecialty Approach

Abstract

The sacrum is a structure that is imaged by both general and subspecialty radiologists. A wide variety of disease processes can involve the sacrum either focally or as part of a systemic process. Plain radiographs, although limited in evaluation of the sacrum, should be carefully examined when abnormalities of the sacrum are suspected. Cross-sectional imaging, particularly computed tomography and magnetic resonance (MR) imaging, plays a crucial role in identification, localization, and characterization of sacral lesions. Congenital lesions of the sacrum, including sacral agenesis and meningocele, are optimally imaged with MR. The most common sacral neoplasm is metastatic disease. Primary neoplasms of the sacrum, which include giant cell tumor, chordoma, and teratoma, are infrequent. Infection of the sacrum or sacroiliac joint is most often due to contiguous spread from a suppurative focus. A wide variety of arthritic disorders such as ankylosing spondylitis and osteoarthritis can involve the sacroiliac joints as part of a localized or systemic process. Sacral fractures related to acute trauma or repetitive stress are difficult to diagnose and treat. Knowledge of these abnormalities and familiarity with the imaging of these processes will allow radiologists of all subspecialties to contribute to the diagnosis and management of sacral disorders.

Etiology of Caudal Regression Syndrome

“…In addition, various other malformations, vertebral and non-vertebral, have occasionally been reported to be associated with the complex [1][2][3][4][5]. CRS occurs at a rate of approximately one per 25,000 live births [6,7]. The condition is caused by some factor or set of factors present during weeks 3-7 of fetal development.…”

Meningocele Anterior Sacro: A Propósito de un Caso

“…La RM es el método de elección para realizar el diagnóstico de los disrafismos espinales. Esta permite clasificar y realizar el planeamiento quirúrgico por su alta resolución de diferenciación tisular, localización de altura del cono medular, así como detección de patologías concomitantes (1,5,6,11,12,14,18,19,22).…”

Type IV lumbosacrococcygeal agenesis infant of diabetic mother

“…LSCA is a rare condition occurring in less than 0.01% of the general population 1 and is characterized by complete sacrococcygeal agenesis, with variable lumbar agenesis. 2 LSCA is both a skeletal and a central nervous system malformation.…”