Sacral insufficiency fracture on bone scan

Case contributed by Dr Matt Skalski

Presentation

Pain

Patient Data

Age: 75 years
Gender: Female
Nuclear medicine

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." 

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