PMID: 9194227May 1, 1997Paper

MR imaging of supra-acetabular insufficiency fractures

Skeletal Radiology
M T OtteR C Fritz

Abstract

Diagnosis of insufficiency fractures in the pelvis is difficult, especially in patients with prior malignancy, irradiation, steroid therapy or osteoporosis. This report shows the MR imaging appearance of supra-acetabular insufficiency fractures and how they can be differentiated from metastatic disease. Twelve patients (four men, eight women, average age 72.8 years) at risk for pelvic insufficiency fractures and who had pelvic or hip pain were studied with MR imaging. Indications were possible recurrent tumor or previous radiation to the pelvis (7 patients); osteoporosis from steroid use in rheumatoid arthritis (two patients); to exclude osteonecrosis of the hip (two patients); or to rule out a hip fracture (one patient). A characteristic linear region of low signal intensity on both T1- and T2-weighted sequences was found in the supra-acetabular region paralleling the superior acetabulum in a curvilinear are in 92% (11/12) of cases, and oblique in origin in 8% (1/11). Diffuse bands of high signal on T2-weighted images indicated surrounding edema. In two cases, MR findings obviated biopsy. One patient underwent a biopsy prior to the imaging studies being reviewed. All patients were treated conservatively and did well. Attention...Continue Reading

Citations

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