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Case Reports in Orthopedics
Volume 2015, Article ID 704393, 4 pages
http://dx.doi.org/10.1155/2015/704393
Case Report

Postpartum Sacral Stress Fracture: An Atypical Case Report

1Institute of Orthopedic and Traumatology, “Agostino Gemelli” Hospital, Catholic University, Largo Gemelli 8, 00168 Rome, Italy
2Institute of Translational Research for Musculoskeletal System “Nicola Cerulli”, Via Einstein 12, 52100 Arezzo, Italy

Received 31 March 2015; Accepted 8 June 2015

Academic Editor: Lars G. Grossterlinden

Copyright © 2015 Andrea Speziali et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sacral stress fractures are common in elderly people. However, sacral stress fracture should be always screened in the differential diagnoses of low back pain during the postpartum period. We present a case of sacral fracture in a thirty-six-year-old woman with low back pain and severe right buttock pain two days after cesarean section delivery of a 3.9 Kg baby. The diagnosis was confirmed by MRI and CT scan, while X-ray was unable to detect the fracture. Contribution of mechanical factors during the cesarean section is not a reasonable cause of sacral fracture. Pregnancy and lactation could be risk factors for sacral stress fracture even in atraumatic delivery such as cesarean section. Our patient had no risk factors for osteoporosis except for pregnancy and lactation. Transient or focal osteoporosis is challenging to assess and it cannot be ruled out even if serum test and mineral density are within the normal range.