PMC8008716_01
Case 1: A) Plain abdominal x-ray showing the prominent loops of bowel usually masking detection of sacral fracture. B) Computed tomography(CT) showing sacral insuffciency fracture extending into the sacral canal, Denis type 2 fractures bilaterally. C) CT scan of the same patient showing incidental old healed pubic symphysis pubic rami fracture, D) CT scan of the same patient showing old healed incidental L4 lumbar spine fracture.
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A plain abdominal and pelvic radiograph showed prominent loops of gaseous bowel (Fig. 1).
PMC8008716_02
Case 2: A) Bone scintigraphy showing classic "H" sign confirming increasing uptake bilateral sacral ala and pubic rami. B) CT scan showing bilateral sacral fractures extending into zone2 and 3of sacrum (as per Denis classfication). C) CT scan of the same patient showing bilateral old healed pubic rami fractures with old per trochanteric fracture of left hip.
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A bone scintigraph, as advised by the radiologist, revealed a high uptake bilaterally in the sacrum and pubis (Fig. 2).