Clinics in diagnostic imaging (60). Insufficiency fractures of the pelvis.

An 80-year-old woman presented with severe low back pain of gradual onset. Her walking ability was affected. Physical examination was essentially negative. Bone scintiscans showed a butterfly-shaped area of increased sacral uptake as well as focal pubic uptake. The diagnosis of sacral and parasymphyseal insufficiency fractures was confirmed by CT. The patient recovered well with conservative management. The clinical and imaging features, and management of insufficiency fractures of the pelvis are discussed.