Bilateral iliac stress fracture in a young male military cadet: report of an unusual case

Abstract

Stress fractures are common in military population. They were first reported in Prussian soldiers’ metatarsals by Breithaupt in 1855 as “march fractures” and their radiographic characteristics were described by Stechow in 1897. Stress fractures occur generally due to bone fatigue and there is a clear distinction be made between fatigue and insufficiency fractures. A repetitive abnormal load upon a normal bone causes a fatigue fracture while a normal load upon a weak and structurally abnormal bone causes an insufficiency fracture. Although the military recruits being usually young and in good general condition are more susceptible to fatigue rather than insufficiency fractures, when diagnosed with a stress fracture it is nevertheless necessary to exclude other causes of bone fragility. Diagnosis may be difficult because the symptoms are non specific and radiographic signs are often absent or subtle. Pelvis is one of the less frequent areas where the fatigue fractures are presented. Moreover, bilateral stress fractures are extremely rare; in the current literature there have been reports for bilateral pedicle, pubic, ischial, femoral, tibial, fibular, calcaneal, scapular, ulnar and scaphoid fractures, but there is no report about an iliac one so far. Case report