Case Author(s): Jerold W. Wallis , 5/11/96 . Rating: #D1, #Q4

Diagnosis: Sacral fracture

Brief history:

Low back/pelvic pain


Anterior and posterior images of the pelvis

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Full history/Diagnosis is available below

Diagnosis: Sacral fracture

Full history:

The patient is an elderly woman with no history of malignancy, who has had low back/pelvic pain since a fall two weeks ago. Radiographs of the pelvis, hips, and lumbar spine demonstrate only degenerative changes in the lumbar spine, and old lumbar compression fractures.


20 mCi Tc-99m MDP, i.v.


Markedly increased uptake is seen in the mid sacrum in a transverse linear distribution, likely also involving the inferior aspect of the sacro-illiac joints.


The findings are diagnostic of a sacral fracture.

Major teaching point(s):

Bone scintigraphy may reveal a fracture which is not evident on plain radiographs.

The appearance of sacral insufficiency fractures is variable; sometimes the vertical components in the sacroiliac joints are more pronounced, giving an "H" configuration to the fracture zone.

ACR Codes and Keywords:

References and General Discussion of Bone Scintigraphy (Anatomic field:Skeletal System, Category:Effect of Trauma)

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Case number: bs059

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