Consecutive Bilateral Iliac Stress Fracture in an Adult Male Runner

TL;DR

A male marathon runner experienced consecutive stress fractures in both iliac bones, highlighting the need for early diagnosis and rest for recovery.

Contribution

This case highlights the rare occurrence of consecutive bilateral iliac stress fractures in an adult male runner.

Findings

The patient developed a right iliac stress fracture confirmed by MRI, followed by a left-sided fracture after returning to running.

Conservative management with rest led to successful recovery and return to preinjury running levels.

MRI is emphasized as a valuable diagnostic tool for identifying iliac stress fractures.

Abstract

Iliac stress fractures (ISF) are uncommon in sports, particularly among runners, and are attributed to repetitive loading and other predisposing factors. ISF poses diagnostic challenges due to nonspecific symptoms and the limited sensitivity of conventional imaging procedures. The reported case is about a 51-year-old male marathon runner with consecutive bilateral ISF. Initial symptoms included mechanical pain in the right buttock, leading to a diagnosis confirmed via pelvic MRI. Conservative management with eight weeks rest from sport activity was indicated with symptom resolution and return to sport. However, 20 days after returning to sport, the patient developed left-sided symptoms post-resumption of running, with MRI confirming a new ISF. An additional eight weeks of rest was prescribed, allowing the patient to resume sport at preinjury levels. ISF should be considered in runners presenting with gluteal pain, emphasizing the importance of early diagnosis. MRI emerges as a valuable tool for accurate diagnosis, guiding appropriate management strategies. Conservative management focusing on rest is paramount for favorable outcomes and optimizing runners' health and performance.

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