Sacral fatigue fracture in a female runner: A case report

Objective: This case report describes and discusses the clinical presentation, diagnosis, and management of a patient with a sacral fatigue fracture. Clinical Features: A 26-year-old female long-distance runner presented with nonspecific low-back and buttock pain that prevented her from training. Intervention and Outcome: Radiographic findings on the patient's lumbar spine and pelvis were interpreted as normal. Single-photon emission computed tomography and magnetic resonance imaging were performed, revealing a fatigue fracture of the left sacral ala. The patient discontinued training for 6 months and gradually returned to running. Conclusions: A high index of suspicion should prompt investigation with skeletal scintigraphy, computed tomography, or magnetic resonance imaging. Sacral stress fractures may respond well to conservative measures if diagnosed in a timely fashion.