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Low back pain in children can be a diagnostic dilemma. Stress fractures affecting the sacrum should be considered in the differential diagnosis of low back pain in children. We report a rare case of sacral stress fracture in a 10 year old that healed with rest, and discuss the pertinent clinical and radiological findings. The diagnosis is often delayed because plain radiographic findings are typically normal and it is best made with skeletal scintigraphy. Computed tomography (CT) or magnetic resonance imaging (MRI) is indicated if there is concern over malignancy or intraspinal pathology.
CASE REPORT
A healthy 10 year old child presented with a two week history of insidious onset and worsening of his mechanical low back and right sided buttock pains. He gave no specific history of trauma but actively participated in school physical education. He described constant pain that worsened with activity and improved with bed rest. He remained doublycontinent and there were no associated lumbar radiculopathy or systemic symptoms.
Physical examination disclosed restricted lumbar spine flexion and extension, and diffuse tenderness in the right buttock over the sacroiliac joint. Right straight leg raise was restricted …