Sacral Insufficiency Fracture – A Case Report

Clinical History: A 66 years old female presented with severe backache and difficulty in walking past many months. The pain exacerbated by walking. No h/o trauma or previous back problems.No radicular symptoms or signs present.

Imaging Findings: Plain radiographs Pelvis (AP) and L-S spine (Lat) were normal. Patient referred for MR imaging.

MRI Findings revealed:
  1. Fracture of the body of S2 extending to both lateral masses of the sacrum; the fracture line on the right side was seen to extend to the body of the S1 vertebra. These areas showed low signal intensity on T1WI and hyperintense signal on T2WI and STIR sequences. (fig 1) On post contrast images, enhancement was seen in the areas of fracture.(fig 2).
  2. Vertebrae showed osteoporotic changes.