Sacral insufficiency fractures are relative common and osteoporosis is the leading cause.

It occurs most often in elderly women.

Chronic steroid use, radiation exposure, and arthritis are other causes.

Patients present with lower back pain that is often associated with trauma.

Radiographic findings that are often normal.

CT scans can show sclerosis and cortical disruption.

MR images can show marrow edema.

Bone scan show increased activity suggestive of a sacral insufficiency fracture.

A normal bone scintigraphy finding excludes a sacral insufficiency fracture as the cause of back pain.

Treatment requires extended bed rest.

Sarcoplasty, the injecting of polymethylmethacrylate cement into sacral insufficiency fractures can provide pain relief.

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