Low-energy pelvic fractures typically occur in elderly patients who sustain ground level falls in the setting of osteopenia/osteoporosis.
This frequently results in a mild type I lateral compression pattern of injury without resultant pelvic instability.
FINDINGS: Mildly displaced fractures of the left sacral ala, inferior pubic ramus and superior pubic ramus. No widening of the sacroiliac joint of pubic symphysis. Hip alignment is maintained.
In patients severe osseous demineralization and reported inability to bear weight, consider rapid MRI of the hip and pelvis for greater sensitivity for fracture detection.
On every study, trace key contour lines and compare joint spaces to assess for asymmetry and fracture, which often appears as subtle cortical disruption or impaction. For history of GLF, look specifically for superior and inferior pubic rami fractures and nondisplaced, impacted sacral alar fractures.
Example report negative for traumatic injury
FINDINGS:
- No acute fracture. The pubic symphysis is normal. The sacroiliac joints are normal.
IMPRESSION:
- No acute fracture or traumatic malalignment.
- If severe pain or nonweight bearing status, consider noncontrast CT or rapid MRI of the hip and pelvis to assess of occult fracture.
- MRI and CT of Insufficency Fractures of the Pelvis and Proximal Femur
- Pelvic Ring Fractures: What the Orthopedic Surgeon Wants to Know.