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Revue du rhumatisme
Volume 68, n° 1
pages 80-83 (janvier 2001)
Received : 15 May 2000 ;  accepted : 24 October 2000
Fracture du sacrum du postpartum sans ostéoporose gravidique
Postpartal sacral fracture without osteoporosis.

Mickaël  Rousière,  André  Kahan,  Chantal  Job-Deslandre
Service de rhumatologie A, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France 

Correspondance et tirés à part
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Les fractures de contrainte du sacrum au cours de la grossesse ou du postpartum semblent un événement rare. Nous rapportons une nouvelle observation de fracture non traumatique du sacrum chez une femme de 36 ans quatre semaines après son premier accouchement. L'originalité de cette observation repose sur la localisation sacrée de la fracture décrite seulement quatre fois dans la littérature. Le bilan biologique usuel est normal en dehors d'une carence vitaminique D, sans ostéomalacie. La densitométrie osseuse (rachidienne et fémorale) est normale. Cette pathologie mérite d'être connue du rhumatologue pour faciliter le diagnostic différentiel des pygalgies de la femme enceinte ou allaitante. L'imagerie par résonance magnétique est l'examen de choix pour confirmer le diagnostic.

Mots clés  : allaitement ; fracture ; grossesse ; ostéoporose ; sacrum.

Abstract

Stress fractures of the sacrum during pregnancy or the postpartum seem uncommon. We report a new case of nontrauma-related postpartal sacral fracture. Only four similar cases have been reported to date. The patient was 36 years of age and her fracture was diagnosed four weeks after her first delivery. Vitamin D levels were low, but there was no osteomalacia. Other standard laboratory tests were normal, as were absorptiometry measurements at the lumbar spine and femur. Rheumatologists should consider sacral fracture in pregnant or nursing patients with buttock pain. Magnetic resonance imaging is the diagnostic investigation of choice.

Mots clés  : fracture ; nursing ; osteoporosis ; pregnancy ; sacrum.




© 2001  Éditions scientifiques et médicales Elsevier SAS. All Rights Reserved.

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