1. Fracture

2.  A fracture is a cracking or breaking of bone tissue and can occur anywhere along the pelvis and its articulations or pain from other fracture sites, such as the low back, may refer to the pelvis. It is also a large risk factor for developing a DVT. Pregnant or postpartum women may experience sacral stress fractures, especially if they are participating in athletic training activities or running.

3. Causes/Risk Factors  Osteoporosis  History of smoking  Paget's disease  Gender (female)  Athletes, military personnel (overuse, overtraining, improper footwear or training surface)  Athletic pregnant or postpartum women  Pelvic radiation  Lumbar-sacral fusion (early postoperative)  Osteomyelitis, TOP, osteoporosis  Multiple myeloma  Trauma (motor vehicle accident, fall, assault, difficult labor during pregnancy)  Prolonged use of corticosteroids

4. Signs and Symptoms  Pelvic fracture  “sign of the buttock”  Limited SLR  Limited hip and trunk flexion  Non-capsular restriction pattern of the hip  Painful and weak hip extension  Gluteal swelling  Empty end-feel with hip flexion  Pubic stress fracture  Gradual onset of groin pain  Intensified with weight bearing, walking, or abduction of the thigh.

5. PT Implications  Referral for medical attention or progress with conservative management if they have already been diagnosed by a physician.

6. References  Dutton, Mark. Orthopaedic Examination, Evaluation, and Intervention. Ed. Nagleieri, Catherine Johnson and Christie. second edition ed2008. Print.  Goodman, Catherine Cavallaro and Snyder, Teresa E. Kelly. Differential Diagnosis for Physical Therapists: Screening for Referral. 2007 ed. Vol. 4th Edition. St. Louis, Missouri: Saunders Elsevier, 2007. Print.