Presentation
Numbness over bum cheeks for the last 6 weeks. Has loss of sensation over inner thirds of bum cheeks bilaterally on examination, nil loss of perianal sensation, Nil urinary/fecal incontinence. Has normal power/tone/reflexes.
Patient Data
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Diffuse high T2 signal on STIR bilaterally in the sacrum. Horizontal fracture line through the mid sacrum at the S2/S3 level.
Normal ilia.
No disc prolapse.
Capacious central canal and exit foramina. No nerve root impingement.
Case Discussion
Appearances in keeping with a sacral fracture.
In the context of no trauma, this is most likely an insufficiency fracture.
Recommend bone density work up including a DEXA scan.