Are sacral stress fractures in young women truly rare? a retrospective MRI analysis of 1970 patients

dc.authorid0000-0003-1777-2800
dc.authorid0009-0000-9515-830X
dc.authorid0000-0002-0201-185X
dc.authorid0000-0002-2356-0268
dc.authorid0000-0003-0995-0953
dc.contributor.authorBayram, Yusuf
dc.contributor.authorDoğan, Selman
dc.contributor.authorYalvaç, Bestami
dc.contributor.authorAksoy, Süleyman Hilmi
dc.contributor.authorKarataş, Muhammed Enes
dc.date.accessioned2026-08-13T07:36:51Z
dc.date.available2026-08-13T07:36:51Z
dc.date.issued2026
dc.departmentMeslek Yüksekokulları, Meslek Yüksekokulu, Tıbbi Görüntüleme Teknikleri Programı
dc.description.abstractBackground Sacral stress/insufficiency fractures (SSFs) are underrecognized causes of postpartum low-back/pelvic pain and are frequently misattributed to lumbar disc disease. To determine the MRI-based detection rate and clinical/ imaging characteristics of SSFs in women aged 18–50 years undergoing lumbosacral MRI, with subgroup analyses for postpartum versus non-postpartum status. Methods Retrospective review of 2400 lumbosacral MRI examinations (January 2020–December 2024) corresponding to 1970 unique women. SSFs were identified by a fellowship-trained musculoskeletal radiologist. Prespecified exclusions (chronic corticosteroid use, major pelvic trauma, incomplete follow-up) yielded the analytic cohort. Group comparisons reported effect sizes (Hedges’ g for continuous; risk difference [RD]/odds ratio [OR] for binary) with 95% CIs. Results Crude MRI-based detection rate: 1.52% (30/1,970; 95% CI, 1.07–2.17); analytic MRI-based detection rate: 1.17% (23/1,970; 95% CI, 0.78–1.75). Median age 34 years (range 22–49); 10/23 (43.5%) postpartum. Five cases (21.7%) were initially misdiagnosed. Fractures most often involved the sacral ala (right 12, left 10, bilateral 1). Compared with non-postpartum patients, postpartum patients had lower hemoglobin (**11.5 vs 12.6 g/dL; p = 0.007; Hedges’ g = 1.21, 95% CI 0.34–2.09) and hematocrit (**33.9% vs 37.3%; p = 0.007; g = 1.21, 95% CI 0.34–2.09); vitamin D was lower but nonsignificant (**15.4 vs 20.3 ng/mL; p = 0.204; g = 0.53, 95% CI − 0.28–1.34). Overall vitamin D status (n = 21): deficient < 20 ng/mL 11/21 (52.4%), insufficient 8/21 (38.1%), sufficient ≥ 30 ng/mL 2/21 (9.5%). The reported frequency reflects an MRI-based detection rate within a selected cohort of symptomatic women undergoing lumbosacral MRI and should not be interpreted as the true population prevalence of sacral stress fractures. Conclusion Sacral stress fractures in young women, particularly in the postpartum period, may be underrecognized in symptomatic patients presenting with persistent lo
dc.identifier.citationBayram, Y., Dogan, S., Yalvaç, B., Aksoy, S. H., & Karatas, M. E. (2026). Are sacral stress fractures in young women truly rare? A retrospective MRI analysis of 1970 patients. Journal of Orthopaedic Surgery and Research, 21(1), Article 442.
dc.identifier.doi10.1186/s13018-026-06941-x
dc.identifier.issue1
dc.identifier.urihttps://hdl.handle.net/20.500.12941/439
dc.identifier.volume21
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.institutionauthorAksoy, Süleyman Hilmi
dc.institutionauthorid0000-0002-2356-0268
dc.language.isoen
dc.publisherBMC
dc.relation.ispartofJournal of Orthopaedic Surgery and Research
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectSacral Stress Fracture
dc.subjectPostpartum
dc.subjectPregnancy
dc.subjectMRI
dc.subjectBone Metabolism
dc.subjectFatigue Fracture
dc.subjectInsufficiency Fracture
dc.titleAre sacral stress fractures in young women truly rare? a retrospective MRI analysis of 1970 patients
dc.typeArticle

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