Postpartum sacral stress fracture associated with mechanical sacroiliac joint disease: A case report

RATIONALE: Stress fractures of the sacrum and mechanical sacroiliac joint disease can occur not only during pregnancy but also postpartum. Mechanical sacroiliac joint disease is common in patients with low back pain but often misdiagnosed by practitioners. The association of the 2 conditions has not been studied yet. PATIENT CONCERNS: A 37-year-old woman physiatrist presented with 8-week history of persistent low back and left buttock pain that started in the third trimester of her pregnancy. DIAGNOSES: Laboratory investigation, dual-energy x-ray absorptiometry, magnetic resonance imaging, and CT of the pelvic region were performed. The patient was diagnosed with postpartum sacral stress fracture associated with mechanical sacroiliac joint disease. INTERVENTIONS: Treatment consisted in pain killers and tailored to a nonweight-bearing period of 3 months. OUTCOMES: Painful symptoms disappeared and the patient was able to walk and perform other daily activities normally. LESSONS: Clinician should be aware of the clinical context and the possible association of these 2 conditions in order to undertake an early and appropriate treatment.