Журнал клинических случаев

Sacral Ala Stress Fracture in a Child

Abstract

Coursier R, Degisors S, Lespessailles E and Toumi H

Difficulties in the diagnosis of stress fractures arise from the nonappearance of radiographic abnormalities in the early stage after the fracture has happened. We report the case of a previously asymptomatic 11-year-old child with no intense physical activity background who presented a stress fatigue fracture of the right sacral ala. Clinical examination disclosed an elective pain located near the right sacro-iliac joint. Neurological examination was normal. All biological tests; spine, pelvis and hips X-Rays were also normal. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) confirmed a fatigue fracture appearance of the right sacral ala. The total healing of the patient was obtained after 4 months of orthopedic treatment. Sacral fatigue fractures remain a rare event, especially in the pediatric non athletic group. Only five cases have been reported so far in the literature. This can lead to multiplying supplementary examinations and delaying diagnosis.