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Sacroiliitis or insufficiency fracture?

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Abstract

Sacral stress fracture and sacroiliitis are two conditions that present with pain. Sacral stress fractures are a rare cause of lumbar and hip pain. Sacral insufficiency fractures are a type of sacral stress fractures. Sacroiliitis represents inflammation of the sacroiliac joints. Coexistence of sacroiliitis and sacral insufficiency fracture (SIF) has not been reported before. Case 1: A 39-year-old woman reporting inflammatory back pain. Imaging revealed bilateral chronic sacroiliitis and bilateral SIF. Case 2: A 31-year-old woman presenting with left hip and inguinal pain. Imaging revealed left sacroiliitis and ipsilateral SIF. Calcium and vitamin D supplementation together with nonsteroidal anti-inflammatory drug (NSAID) treatment were given. Sulfasalazine was added to the treatment of the second patient who developed peripheral arthritis during follow-ups. Early diagnosis is best made with magnetic resonance imaging (MRI) since roentgenograms may be negative initially. Furthermore, MRI findings of both entities share common features leading to a diagnostic dilemma. Interpretation of radiological findings assisted by detailed history and clinical findings is crucial for diagnosis and treatment.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey

    O. G. Memetoğlu, F. U. Ozkan, I. Aktas & A. Taraktas

  2. Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey

    N. S. Boy

  3. Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey

    D. G. Kulcu

Authors
  1. O. G. Memetoğlu
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  2. F. U. Ozkan
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  3. N. S. Boy
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  4. I. Aktas
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  5. D. G. Kulcu
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  6. A. Taraktas
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Corresponding author

Correspondence to O. G. Memetoğlu.

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Memetoğlu, O.G., Ozkan, F.U., Boy, N.S. et al. Sacroiliitis or insufficiency fracture?. Osteoporos Int 27, 1265–1268 (2016). https://doi.org/10.1007/s00198-015-3363-z

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  • DOI: https://doi.org/10.1007/s00198-015-3363-z

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