Sacral Stress Fractures in Children

Abstract not available. Introduction provided instead.

Sacral stress fractures are well documented in the literature. These fractures result from mechanical overload of healthy bone in both young athletic and military populations (fatigue fractures) or from osteoporosis in the elderly (insufficiency fractures).

In this article, we present the case of a girl (age, 9 years 11 months) with a sacral fatigue fracture. An active soccer player, she presented with left buttock pain of 3 weeks’ duration. A plain radiograph of her pelvis was unremarkable. Magnetic resonance imaging of the pelvis showed a sacral stress fracture. After 1 month of activity modification, symptoms improved; by 14 weeks, the patient had returned to preinjury activity levels.

In describing this rare entity, we hope to increase awareness of it among orthopedic surgeons and primary care physicians. The natural history of stress fractures in children and skeletally immature adolescents is usually benign, but the differential diagnosis includes infection, a benign tumor, and, more alarmingly, a bone and soft-tissue malignancy. Therefore, having a high index of suspicion and making an accurate diagnosis can help in avoiding unnecessary, more invasive procedures and treatment options.