Presentation
Pain
Patient Data

Intense abnormal uptake is present in the sacrum with an H-shaped morphology, typical of sacral insufficiency fracture.
Intense uptake is also noted at the right superior and inferior pubic rami, at sites of known prior fracture.
Activity involving the left knee, consistent with osteoarthritis. Some activity is also noted in the lower lumbar spine at the site of surgical fusion.

Bilateral sclerotic changes in the sarcral ala with linear areas of central lucency consistent with insufficiency fracture.
Case Discussion
Typical example of sacral insufficiency fracture in an elderly osteoporotic female with the classic "Honda sign."