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Abstract：
METHODS: Retrospective study.
OBJECTIVE: To investigate the clinical manifestations of a fragility fracture of the sacrum (FFS) and the factors that may contribute to a misdiagnosis.
BACKGROUND: The number of patients diagnosed with FFS has increased because of extended life expectancy and osteoporosis. Patients with FFS may report nonspecific symptoms, such as back, buttock, groin, and/or leg pain, leading to a misdiagnosis and a delay in definitive diagnosis.
METHODS: Fifty-six patients (13 males and 43 females) with an average age of 80.2±9.2 years admitted to the hospital for FFS between 2006 and 2021 were analyzed retrospectively. The following patient data were collected using medical records: pain regions, a history of trauma, initial diagnoses, and rates of fracture detection using radiography, computed tomography (CT), and magnetic resonance imaging (MRI).
RESULTS: Forty-one patients presented with low back and/or buttock pain, nine presented with groin pain, and 17 presented with thigh or leg pain. There was no history of trauma in 18 patients (32%). At the initial visit, 27 patients (48%) were diagnosed with sacral or pelvic fragility fractures. In contrast, 29 patients (52%) were initially misdiagnosed with lumbar spine disease (23 patients), hip joint diseases (three patients), and buttock bruises (three patients). Fracture detection rates for FFS were 2% using radiography, 71% using CT, and 93% using MRI. FFS was diagnosed definitively using an MRI with a coronal short tau inversion recovery (STIR) sequence.
CONCLUSIONS: Some patients with FFS have leg pain with no history of trauma and are initially misdiagnosed as having lumbar spine disease, hip joint disease, or simple bruises. When these clinical symptoms are reported, we recommend considering FFS as one of the differential diagnoses and performing lumbar or pelvic MRIs, particularly coronal STIR images, to rule out FFS.
OBJECTIVE: To investigate the clinical manifestations of a fragility fracture of the sacrum (FFS) and the factors that may contribute to a misdiagnosis.
BACKGROUND: The number of patients diagnosed with FFS has increased because of extended life expectancy and osteoporosis. Patients with FFS may report nonspecific symptoms, such as back, buttock, groin, and/or leg pain, leading to a misdiagnosis and a delay in definitive diagnosis.
METHODS: Fifty-six patients (13 males and 43 females) with an average age of 80.2±9.2 years admitted to the hospital for FFS between 2006 and 2021 were analyzed retrospectively. The following patient data were collected using medical records: pain regions, a history of trauma, initial diagnoses, and rates of fracture detection using radiography, computed tomography (CT), and magnetic resonance imaging (MRI).
RESULTS: Forty-one patients presented with low back and/or buttock pain, nine presented with groin pain, and 17 presented with thigh or leg pain. There was no history of trauma in 18 patients (32%). At the initial visit, 27 patients (48%) were diagnosed with sacral or pelvic fragility fractures. In contrast, 29 patients (52%) were initially misdiagnosed with lumbar spine disease (23 patients), hip joint diseases (three patients), and buttock bruises (three patients). Fracture detection rates for FFS were 2% using radiography, 71% using CT, and 93% using MRI. FFS was diagnosed definitively using an MRI with a coronal short tau inversion recovery (STIR) sequence.
CONCLUSIONS: Some patients with FFS have leg pain with no history of trauma and are initially misdiagnosed as having lumbar spine disease, hip joint disease, or simple bruises. When these clinical symptoms are reported, we recommend considering FFS as one of the differential diagnoses and performing lumbar or pelvic MRIs, particularly coronal STIR images, to rule out FFS.
摘要：
方法：回顾性研究。
目的：探讨骶骨脆性骨折（FFS）的临床表现及误诊原因。
背景：由于预期寿命延长和骨质疏松症，诊断为FFS的患者数量有所增加。FFS患者可能报告非特异性症状，比如背部，臀部,腹股沟,和/或腿部疼痛，导致误诊和延迟确诊。
方法：回顾性分析2006年至2021年住院FFS患者56例（男13例，女43例），平均年龄80.2±9.2岁。使用医疗记录收集以下患者数据：疼痛区域，创伤史,初步诊断，以及使用射线照相术的骨折检出率，计算机断层扫描（CT），磁共振成像（MRI）。
结果：41例患者出现下背部和/或臀部疼痛，九人腹股沟疼痛，17人表现为大腿或腿部疼痛。18例（32%）患者无外伤史。在初次访问时,27例（48％）被诊断为骶骨或骨盆脆性骨折。相比之下,29例(52%)最初误诊为腰椎疾病(23例),髋关节疾病（三名患者），和臀部瘀伤（三个病人）。FFS的骨折检出率为2%，71%使用CT，93%使用MRI。使用具有冠状短tau倒置恢复（STIR）序列的MRI明确诊断FFS。
结论：一些FFS患者有腿部疼痛，没有外伤史，最初被误诊为腰椎疾病，髋关节疾病,或者简单的瘀伤.当这些临床症状被报道时，我们建议将FFS作为鉴别诊断之一，并进行腰椎或骨盆MRI，特别是冠状刺激图像，排除FFS.
目的：探讨骶骨脆性骨折（FFS）的临床表现及误诊原因。
背景：由于预期寿命延长和骨质疏松症，诊断为FFS的患者数量有所增加。FFS患者可能报告非特异性症状，比如背部，臀部,腹股沟,和/或腿部疼痛，导致误诊和延迟确诊。
方法：回顾性分析2006年至2021年住院FFS患者56例（男13例，女43例），平均年龄80.2±9.2岁。使用医疗记录收集以下患者数据：疼痛区域，创伤史,初步诊断，以及使用射线照相术的骨折检出率，计算机断层扫描（CT），磁共振成像（MRI）。
结果：41例患者出现下背部和/或臀部疼痛，九人腹股沟疼痛，17人表现为大腿或腿部疼痛。18例（32%）患者无外伤史。在初次访问时,27例（48％）被诊断为骶骨或骨盆脆性骨折。相比之下,29例(52%)最初误诊为腰椎疾病(23例),髋关节疾病（三名患者），和臀部瘀伤（三个病人）。FFS的骨折检出率为2%，71%使用CT，93%使用MRI。使用具有冠状短tau倒置恢复（STIR）序列的MRI明确诊断FFS。
结论：一些FFS患者有腿部疼痛，没有外伤史，最初被误诊为腰椎疾病，髋关节疾病,或者简单的瘀伤.当这些临床症状被报道时，我们建议将FFS作为鉴别诊断之一，并进行腰椎或骨盆MRI，特别是冠状刺激图像，排除FFS.
