OLGU SUNUMLARI
Osteoporotik Yaşlı Bir Kadında Tanı Konulamayan Sakral Yetmezlik Kırığı
An Undiagnosed Sacral Insufficiency Fracture in an Osteoporotic Elderly Woman
Received Date : 13 Sep 2022
Accepted Date : 08 Feb 2023
Available Online : 13 Feb 2023
Cevriye MÜLKOĞLUa, Ömer Faruk ÇELİKa, İbrahim TAKAa, Burcu DUYUR ÇAKITa
aClinic of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Türkiye
Doi: 10.31609/jpmrs.2022-93000 - Makale Dili: EN
J PMR Sci. 2023;26(2):239-42
ÖZET
Yetmezlik fraktürleri, mineralizasyonu ve elastik direnci düşük kemiğe
normal bir stres uygulandığında oluşur. Postmenopozal osteoporoz,
hamilelik, postpartum dönem ve spor aktiviteleri yetmezlik kırıklarına neden
olabilir. Sakral yetmezlik kırığında klinik şüphe önemlidir. Tanı konulamayan
olgularda bilgisayarlı tomografi, sintigrafi ve manyetik rezonans görüntüleme
kullanılmaktadır. Ağrı kontrolü için yatak istirahati,
analjezikler-antiinflamatuar ilaçlar ve fizik tedavi modaliteleri uygulanabilir.
Tedaviye yanıt alınamayan bel ve/veya kalça ağrısı olan ileri yaş osteoporotik
hastalarda sakral yetmezlik kırığı mutlaka akılda tutulmalıdır. Bu
olgu sunumunda, gözden kaçan sakral yetmezlik kırığı olan 77 yaşında bir
hastayı sunacağız. Üç aydır dirençli bel ve kalça ağrısı olan hasta sakroileit
olarak yanlış tanı almıştı.
Anahtar Kelimeler: Yetmezlik fraktürü; bel ağrısı; hafif dereceli travma; manyetik rezonans görüntüleme
ABSTRACT
Insufficiency fractures occur when normal stress is applied
to bone with low mineralization and elastic resistance. Postmenopausal osteoporosis,
pregnancy, postpartum period and sports activities can result in
insufficiency fractures. Clinical suspicion is important in sacral insufficiency
fractures. Computed tomography, scintigraphy and magnetic resonance
imaging are used in undiagnosed cases. Bed rest, analgesics, anti-inflammatory
drugs and physical therapy modalities can be used for pain control.
Sacral insufficiency fracture should be kept in mind in elderly osteoporotic
patients with low back and/or hip pain unresponsive to treatment. In this
case report, we will present a 77-year-old patient with overlooked sacral insufficiency
fracture. The patient, who had persistent low back and hip pain
for three months, was misdiagnosed as sacroiliitis.
Keywords: Insufficiency fracture; low back pain; microtrauma; magnetic resonance imaging
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