A Tc-99m MDP bone scan and pelvic radiograph were performed in a 73-year-old man with prostate cancer. The bone scan showed widespread skeletal metastases and an unusual appearance in the left hemipelvis with apparent separation of the lateral ilium. The radiograph showed multiple sclerotic metastases and a vertical fracture through the left ilium that in the absence of severe trauma would be most unusual. The patient had no pain in his pelvis and walked without difficulty. He was taking opiates for back pain and gave a history of several minor falls at home, such as tripping over the family dog.
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