Ischiopubic insufficiency fractures: MRI appearances

Objective. To evaluate the MRI appearances in insufficiency fractures. Design. A retrospective analysis of spin echo MR images with gadolinium-enhancement was undertaken with the emphasis on the signal change and the shape of the fracture gap and the adjacent bone marrow. Patients. Five elderly women who had ischiopubic insufficiency fractures (pubis, 4; ischium 1) underwent MRI to exclude the possibility of pathologic fractures. Results and conclusions. In no case was contrast enhancement noted at the fracture gap or the adjacent bone marrow, but a cleft-life, elongated bright signal area suggesting “fluid collection” was noted within the fracture gap. Absence of contrast enhancement and “fluid collection” at the fracture gap might suggest nonunion of a fracture, which is additional information provided only by MRI.