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Sacral Stress Fractures in Long-Distance Runners

Nancy M. Major1 and Clyde A. Helms

1 Both authors: Department of Radiology, Duke University Medical Center, P. O. Box 3808, Durham, NC 27710.



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  		Fig. 1. —49-year-old man training for ultramarathon by running approximately 70 miles (112 km) weekly. Axial CT scan through pelvis shows linear lucency (arrow) through cortex of left ala sacralis. Note increased sclerosis along region of sacral foramen.

 


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  		Fig. 2A. —18-year-old female cross-country runner who averages 50-60 miles (80-96 km) of running a week. Axial CT scan shows bilateral disruption (arrows) of cortex of ala sacralis. Note increased sclerosis in ala sacralis bilaterally. Note vacuum phenomenon in sacroiliac joints.

 


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  		Fig. 2B. —18-year-old female cross-country runner who averages 50-60 miles (80-96 km) of running a week. CT scan reveals increased sclerosis along both sacral alae (curved arrows). Note linear lucency (straight arrow) in right sacral ala.

 


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  		Fig. 3A. —42-year-old man training for ultramarathon by running approximately 75 miles (120 km) a week. Axial T1-weighted spin echo MR image reveals linear vertically oriented low signal (arrows) in left ala sacralis that parallels sacroiliac joint.

 


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  		Fig. 3B. —42-year-old man training for ultramarathon by running approximately 75 miles (120 km) a week. Axial fast spin-echo T2-weighted MR image with fat suppression (TR/TEeff, 3450/90) at same level as A shows area of high signal intensity (arrows) in left ala sacralis. Appearance is characteristic of stress fracture in sacrum.

 

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