Pelvic fractures

Case contributed by Dr Andrew Dixon

Presentation

Car accident. (Hot Read)

Patient Data

Age: 20
Gender: Male
X-ray

Trauma Series

Bilateral superior and inferior pubic rami fractures and right sacral ala fracture. Normal SI joint and pubic symphysis alignment. Several sharp foreign bodies with appearance and density consistent with glass are projected near the left hip.     

CT

Pelvic CT

Bilateral superior and inferior pubic rami fractures and right sacral ala fracture. The fragments of glass on the pelvic radiograph are shown to be external to the patient. Note the sizeable pre-sacral haematoma. Haemorrhage in this location should always prompt a search for a sacral fracture. In this case the fracture is obvious, however in many cases the fracture can be subtle and the haemorrhage may help alert the reader to look closer. 

Case Discussion

Pubic rami and right sacral ala fractures. On the CT a pre-sacral haematoma is seen without active bleeding. Haemorrhage in this location is easy to detect (even a trace amount) and is a high yield check area in trauma imaging. If haemrrohage is present, then this should always prompt a search for a sacral fracture. In this case the fracture is obvious, however in many cases the fracture can be subtle and the haemorrhage may help alert the reader to take look closer. 

PlayAdd to Share

Case information

rID: 31674
Case created: 20th Oct 2014
Last edited: 24th Nov 2015
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.