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Superiority of MRI for Evaluation of Sacral Insufficiency Fracture

Study Design: Retrospective observational study. Background: Sacral insufficiency fractures (SIF) are relatively rare fractures and difficult to diagnose on plain radiographs. The primary objective of the present study was to evaluate the role of lumbar magnetic resonance imaging (MRI) for the diagn...

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Autores principales: Yamauchi, Taro, Sharma, Sagar, Chandra, Sarath, Tanaka, Masato, Fujiwara, Yoshihiro, Arataki, Shinya, Sharma, Ayush, Yokoyama, Yusuke, Oomori, Toshinori, Kanamaru, Akihiro, Masuda, Shin, Shimizu, Noriyuki, Torigoe, Kenta, Honda, Osamu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9456416/
https://www.ncbi.nlm.nih.gov/pubmed/36078896
http://dx.doi.org/10.3390/jcm11174968
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author Yamauchi, Taro
Sharma, Sagar
Chandra, Sarath
Tanaka, Masato
Fujiwara, Yoshihiro
Arataki, Shinya
Sharma, Ayush
Yokoyama, Yusuke
Oomori, Toshinori
Kanamaru, Akihiro
Masuda, Shin
Shimizu, Noriyuki
Torigoe, Kenta
Honda, Osamu
author_facet Yamauchi, Taro
Sharma, Sagar
Chandra, Sarath
Tanaka, Masato
Fujiwara, Yoshihiro
Arataki, Shinya
Sharma, Ayush
Yokoyama, Yusuke
Oomori, Toshinori
Kanamaru, Akihiro
Masuda, Shin
Shimizu, Noriyuki
Torigoe, Kenta
Honda, Osamu
author_sort Yamauchi, Taro
collection PubMed
description Study Design: Retrospective observational study. Background: Sacral insufficiency fractures (SIF) are relatively rare fractures and difficult to diagnose on plain radiographs. The primary objective of the present study was to evaluate the role of lumbar magnetic resonance imaging (MRI) for the diagnosis of SIF. The secondary objective was to identify the classification of SIF by computed tomography (CT). Methods: A total of 77 (Male 11, female 66, mean 80.3 years) people were included in this study. Inclusion criteria for this study were: age ≥ 60 years and no history of high energy trauma. Exclusion criteria were high energy trauma and a current history of malignancy. Differences in the fracture detection and description in the various radiologic procedures were evaluated. Fracture patterns were evaluated with CT. The detection rates of additional pathologies in the MRI of the pelvis and lumbar spine were also recorded. Results: The sensitivities for SIF were 28.5% in radiographs and 94.2% in CT, and all fractures were detected in MRI. MRI showed a more complex fracture pattern compared with CT in 65% of the cases. We observed 71.4% of single SIFs, 9.1% with other spinal fractures, 13.0% with other pelvic fractures, and 7.8% with other fractures. According to the SIF fracture pattern, the H/U type was 40.2%, transverse type was 33.7%, λ/T type was 24.7%, unilateral vertical type was 1.3%, and bilateral vertical type was 0%. Conclusions: an MRI of the lumbar spine including the sacrum with a coronal fat-suppressed T2-weighted image is useful for elderly patients with suddenly increasing low back pain at an early stage. This procedure improves an early SIF detection, recognition of concomitant pathologies, and adequate treatment for the patients.
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spelling pubmed-94564162022-09-09 Superiority of MRI for Evaluation of Sacral Insufficiency Fracture Yamauchi, Taro Sharma, Sagar Chandra, Sarath Tanaka, Masato Fujiwara, Yoshihiro Arataki, Shinya Sharma, Ayush Yokoyama, Yusuke Oomori, Toshinori Kanamaru, Akihiro Masuda, Shin Shimizu, Noriyuki Torigoe, Kenta Honda, Osamu J Clin Med Article Study Design: Retrospective observational study. Background: Sacral insufficiency fractures (SIF) are relatively rare fractures and difficult to diagnose on plain radiographs. The primary objective of the present study was to evaluate the role of lumbar magnetic resonance imaging (MRI) for the diagnosis of SIF. The secondary objective was to identify the classification of SIF by computed tomography (CT). Methods: A total of 77 (Male 11, female 66, mean 80.3 years) people were included in this study. Inclusion criteria for this study were: age ≥ 60 years and no history of high energy trauma. Exclusion criteria were high energy trauma and a current history of malignancy. Differences in the fracture detection and description in the various radiologic procedures were evaluated. Fracture patterns were evaluated with CT. The detection rates of additional pathologies in the MRI of the pelvis and lumbar spine were also recorded. Results: The sensitivities for SIF were 28.5% in radiographs and 94.2% in CT, and all fractures were detected in MRI. MRI showed a more complex fracture pattern compared with CT in 65% of the cases. We observed 71.4% of single SIFs, 9.1% with other spinal fractures, 13.0% with other pelvic fractures, and 7.8% with other fractures. According to the SIF fracture pattern, the H/U type was 40.2%, transverse type was 33.7%, λ/T type was 24.7%, unilateral vertical type was 1.3%, and bilateral vertical type was 0%. Conclusions: an MRI of the lumbar spine including the sacrum with a coronal fat-suppressed T2-weighted image is useful for elderly patients with suddenly increasing low back pain at an early stage. This procedure improves an early SIF detection, recognition of concomitant pathologies, and adequate treatment for the patients. MDPI 2022-08-24 /pmc/articles/PMC9456416/ /pubmed/36078896 http://dx.doi.org/10.3390/jcm11174968 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yamauchi, Taro
Sharma, Sagar
Chandra, Sarath
Tanaka, Masato
Fujiwara, Yoshihiro
Arataki, Shinya
Sharma, Ayush
Yokoyama, Yusuke
Oomori, Toshinori
Kanamaru, Akihiro
Masuda, Shin
Shimizu, Noriyuki
Torigoe, Kenta
Honda, Osamu
Superiority of MRI for Evaluation of Sacral Insufficiency Fracture
title Superiority of MRI for Evaluation of Sacral Insufficiency Fracture
title_full Superiority of MRI for Evaluation of Sacral Insufficiency Fracture
title_fullStr Superiority of MRI for Evaluation of Sacral Insufficiency Fracture
title_full_unstemmed Superiority of MRI for Evaluation of Sacral Insufficiency Fracture
title_short Superiority of MRI for Evaluation of Sacral Insufficiency Fracture
title_sort superiority of mri for evaluation of sacral insufficiency fracture
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9456416/
https://www.ncbi.nlm.nih.gov/pubmed/36078896
http://dx.doi.org/10.3390/jcm11174968
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