‘Her pelvis had fractured’: Orthopaedic surgeon shares case of woman with lower abdomen pain mistaken as period ache

‘Her pelvis had fractured’: Orthopaedic surgeon shares case of woman with lower abdomen pain mistaken as period ache

Orthopaedic surgeon Dr Obaidur Rahman recently highlighted the case of a patient, which left him “silent”. “As a surgeon, I’ve fixed broken bones, torn ligaments, and shattered joints. But this one case…left me silent. She was 24. A dancer. Confident, smiling, high energy. She walked into my clinic holding her lower abdomen. “I think it’s just my periods again,” she said. ‘It comes every month… I’ve gotten used to it’.”

While he noticed no limp, no swelling, and “just pain that comes and goes”, worse after long rehearsals and better with painkillers, he asked her about her periods. “Sometimes they come. Sometimes not. I’ve learned to live with it,” she said, “like she was apologising,” Dr Rahman added.

About to send her home, the doctor said he noticed “the way she winced while standing up.” “The way her foot dragged slightly, it stayed with me. I ordered an MRI.”

The MRI revealed that “her pelvis had fractured”. “A clean stress fracture through the pubic bone. No accident. No fall. Just months of starvation, skipped periods, and silence. Her bones had been cracking while she danced, and she was on a diet.”

Her blood reports also noted that her Vitamin D was critically low, estrogen was suppressed, she was anemic, with a bone scan revealing early osteoporosis.

“She didn’t need painkillers. She needed to be rescued… from the idea that being lean equals being healthy,” said Dr Rahman in a post on Instagram.

Taking a cue from this case, let’s examine how a pelvis fracture can be a silent threat and what causes it.

Dr Nikhil Bharambe, a consultant orthopedic surgeon, Medicover Hospitals, Kharghar Navi Mumbai, said that the lower abdomen or pelvic area can suffer fractures or ruptures, especially involving the pelvic bones.

“These injuries can happen because of high-impact trauma such as road accidents, falls from height, or severe sports injuries. In rare cases, even sudden forceful muscle contraction or underlying bone weakness (such as osteoporosis), malignancies, metastasis, and geriatric patients can lead to fractures or ruptures,” said Dr Bharambe.

What makes pelvic injuries complicated is that symptoms aren’t always apparent at first, remarked Dr Bharambe.

“Many patients will fail to notice the symptoms. Therefore, some patients may not experience sharp pain immediately, especially if the fracture is stable or if the internal bleeding is slow. This can delay diagnosis. Watch for subtle signs such as groin discomfort, difficulty walking, lower abdominal pain, or unexplained bruising. As in the case, it is common that lower abdominal pain in women can be mistaken for periods,” said Dr Bharambe.

If ignored, pelvic fractures can cause complications like nerve damage or bladder/bowel issues, said Dr Bharambe. “Timely diagnosis and medical attention are crucial, especially after trauma. So, be careful and consult an expert for an appropriate diagnosis,” said Dr Bharambe.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.