Cooccurrence of Fragility Fracture of the Pelvis with Lumbar Degenerative Disease: A Case Report.

Introduction: Fragility fractures of the pelvis (FFP) are caused by low-energy impacts and can occur spontaneously in patients with severe osteoporosis. The clinical symptoms of FFP are frequently vague and nonspecific. Moreover, the symptoms of FFP can mimic lumbar spine pathologies. Therefore, accurate diagnosis of FFP is often difficult and the fracture may be misdiagnosed as lumbar degenerative disease. However, little is known regarding what kind of symptoms due to lumbar degenerative disease are similar to the symptoms of FFP.

Case Report: We encountered two cases in which FFP developed during the treatment of lumbar degenerative disease with radiculopathy. Both patients had undergone conservative treatment for lumbar degenerative disease, but their symptoms gradually worsened and they presented with gait disturbance. FFP was diagnosed by imaging, and surgery was required in one case. Both cases showed L3 foraminal stenosis on the image, and the symptoms of L3 radiculopathy presented with thigh pain, hip pain, and knee pain, which is similar to the pain site of FFP. Therefore, diagnosis of FFP was difficult.

Conclusion: In lumbar degenerative diseases presenting with radiculopathy, the pain site may be similar to that of FFP, which may make diagnosis of FFP difficult. Therefore, especially in patients with lumbar degenerative disease presenting with L3 radiculopathy, it is necessary to consider the possibility of FFP and perform MRI imaging to make an early diagnosis when the symptoms change.