29-year-old long-distance athlete presenting with 3 weeks of sciatica associated with an increase of running training loads
What do you see?
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IMAGING FINDINGS:
Unilateral sacral bone edema T2W, STIR hyperintensity associated with hypointense fracture line
DIAGNOSIS:
Fatigue stress fracture
TEACHING POINTS:
The sacrum is a frequent site for stress fractures
They can be related to overload occurring in a healthy bone as in this case, or related to osteoporosis (insufficiency stress fractures) in which cases they tend to be bilateral and “h- shaped”