Sacral stress fracture in a young healthy athlete

Abstract

A healthy 25-yr-old male weightlifter presented with a 1-yr history of atraumatic right buttock pain. His pain had increased over time and was limiting his ability to exercise. At the time of presentation, he could not bear weight on the right buttock in the sitting or supine position. His gait was antalgic, favoring the right. There was increased fullness of the right gluteal muscles compared with the left, with tenderness in the region of the right sacroiliac joint. Active right hip flexion was painful. Strength, sensation, and reflexes were normal in the bilateral lower limbs. Fabere test was positive on the right.

Figure 1

Coronal T1 image (A) demonstrates a fracture line involving predominantly the fibrous portion of both sides of the right sacroiliac joint, with associated edema demonstrated on image (B).