婦癌放射線治療致骨盆不全性骨折

Pelvic Insufficiency Fracture after Radiotherapy

骨盆不全性骨折常見於骨質疏鬆的長者，常在無外傷或輕度扭跌後出現，但也有出現在接受放射線治療的婦癌患者，此時，因骨盆不全性骨折會有嚴重下背疼痛和臀部疼痛，常被誤診為腫瘤病灶轉移至骨骼所致。診斷方式可採放射線攝影、核子攝影、電腦斷層和磁振攝影等；治療目標主在針對骨質疏鬆，改善並恢復患者行動與平衡等功能。

Pelvic insufficiency fracture (PIF) is a fracture occurring after normal physiologicalstress on underlying weakened bone with decreased elastic resistance.PIF can occur as a complication after radiotherapy in gynecologic cancers. Itwas defined as a fracture line with or without sclerotic changes in the pelvicbones. The fracture can present as severe low back and sacral pain, radiatinginto the buttock or leg. In gynecologic cancer patients after radiotherapy, PIFcan be misinterpreted as bone metastases. Plain radiography is the primaryscreening tool for diagnosis of PIF and advanced imaging studies such as bonescan, computed tomography and magnetic resonance imaging can be used. Theprimary treatment goals in the osteoporotic patient are centered in improvingmobility and balance to restore pre-injury autonomy.