Osteoporotic Insufficiency Fractures of the Pelvis Simulating a Malignancy in an Elderly Man

Abstract not available. Introduction provided instead.

Insufficiency fracture is a common initial presentation of osteoporosis. Fractures of the distal radius are the most common, followed by fractures of the hip, vertebral body, and proximal humerus.¹ Insufficiency fractures of the pelvis are rare, often unrecognized, and reported mostly in females.^2,3 In their review of the literature, Weber and colleagues³ found that only 17 (7.4%) of 231 insufficiency fractures of the sacrum occurred in males. Although widely regarded as a disease of women, osteoporosis causes significant unrecognized morbidity and mortality in men.⁴ The absolute number of men presenting with osteoporotic fractures is rising because of an increase in the elderly population plus an age-related increased incidence of fractures.⁴ Awareness of this entity, particularly in males, should prevent its being confused with malignant disease, should prevent unnecessary extensive workup, and will allow appropriate management and patient reassurance. In this article, we report the case of an elderly man who had multiple pelvic metachronous insufficiency fractures with worrisome radiologic features simulating a malignancy.