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. 2022 Feb 23;51(9):1721–1730. doi: 10.1007/s00256-022-04018-4

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 6 — Fatigue fracture of the left sacrum in a patient with extensive sporting activities. On radiography it can be hard to distinguish erosion from superposition of bowel gas (arrow heads). Cross-sectional imaging shows bone marrow edema (arrow) but no typical erosions or fat lesions. The distribution of imaging findings (unilaterally and in the sacrum) and the patient’s history (extensive horse riding) point towards a more mechanical genesis—a fatigue fracture