A case of sacral fatigue fracture with initially suspected metastatic sacral tumor

Abstract

Sacral fatigue fractures are often seen in athletes and elderly patients with osteoporosis, and we have experienced a case of man in his 50s in whom we initially suspected metastatic sacral tumor. The patient was 173 cm tall, weighed 100 kg, started working as garbage collector. He had pain in the coccyx around. The pain spread from his right hip to the posterior of his lower extremity, making it difficult for him to walk. He was referred to our pain clinic due to severe pain. A lumbar spine MRI T1-weighted sacral coronal sectional image was taken, and a metastatic sacral tumor was suspected. A CT scan taken revealed a sacral fatigue fracture. The patient's pain gradually decreased, and the oxycodone dose was reduced and discontinued, and the patient was finally diagnosed. The diagnosis of sacral fatigue fracture requires a thorough history of the patient's life, and MRI imaging is essential to obtain adequate views of the sacral region.