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OLGU SUNUMLARI

Osteoporotik Yaşlı Bir Kadında Tanı Konulamayan Sakral Yetmezlik Kırığı
An Undiagnosed Sacral Insufficiency Fracture in an Osteoporotic Elderly Woman
Received Date : 13 Sep 2022
Accepted Date : 08 Feb 2023
Available Online : 13 Feb 2023
Doi: 10.31609/jpmrs.2022-93000 - Makale Dili: EN
J PMR Sci. 2023;26(2):239-42
ÖZET
Yetmezlik fraktürleri, mineralizasyonu ve elastik direnci düşük kemiğe normal bir stres uygulandığında oluşur. Postmenopozal osteoporoz, hamilelik, postpartum dönem ve spor aktiviteleri yetmezlik kırıklarına neden olabilir. Sakral yetmezlik kırığında klinik şüphe önemlidir. Tanı konulamayan olgularda bilgisayarlı tomografi, sintigrafi ve manyetik rezonans görüntüleme kullanılmaktadır. Ağrı kontrolü için yatak istirahati, analjezikler-antiinflamatuar ilaçlar ve fizik tedavi modaliteleri uygulanabilir. Tedaviye yanıt alınamayan bel ve/veya kalça ağrısı olan ileri yaş osteoporotik hastalarda sakral yetmezlik kırığı mutlaka akılda tutulmalıdır. Bu olgu sunumunda, gözden kaçan sakral yetmezlik kırığı olan 77 yaşında bir hastayı sunacağız. Üç aydır dirençli bel ve kalça ağrısı olan hasta sakroileit olarak yanlış tanı almıştı.
ABSTRACT
Insufficiency fractures occur when normal stress is applied to bone with low mineralization and elastic resistance. Postmenopausal osteoporosis, pregnancy, postpartum period and sports activities can result in insufficiency fractures. Clinical suspicion is important in sacral insufficiency fractures. Computed tomography, scintigraphy and magnetic resonance imaging are used in undiagnosed cases. Bed rest, analgesics, anti-inflammatory drugs and physical therapy modalities can be used for pain control. Sacral insufficiency fracture should be kept in mind in elderly osteoporotic patients with low back and/or hip pain unresponsive to treatment. In this case report, we will present a 77-year-old patient with overlooked sacral insufficiency fracture. The patient, who had persistent low back and hip pain for three months, was misdiagnosed as sacroiliitis.
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