Osteoporotic sacral insufficiency fractures in a patient with alternating buttock pain: a case report

Lower back and buttock pain in older adults is often attributed to lumbar or hip degenerative pathology.1 However, in patients with multimorbidity, particularly those with malignancy or osteoporosis, broader causes must be considered. We present a 71-year-old female with three episodes of intractable, alternating buttock pain over 12 months, diagnosed with bilateral sacral insufficiency fractures (SIFs) upon orthopaedic consultation. This case illustrates the diagnostic challenge of SIFs and the importance of multidisciplinary management in fragility fracture care.