What causes Honda sign in sacrum on bone scan?
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Answer:
The Honda sign represents an H-shaped pattern of increased radiotracer uptake on technetium-99m bone scintigraphy due to bilateral sacral insufficiency fractures, typically occurring in osteoporotic postmenopausal women or patients with other metabolic bone diseases predisposing to fragility fractures.
Why is it called so?
The Honda sign is named for its resemblance to the H-shaped logo of the Honda car manufacturer, with vertical uptake in both sacral alae medial to the sacroiliac joints connected by a horizontal band of uptake across the sacrum.
Pathophysiology
Sacral insufficiency fractures arise from normal stress on weakened bone in the setting of osteoporosis or other conditions reducing bone density; fractures propagate vertically through the sacral alae paralleling the sacroiliac joints and horizontally through the sacral body at S2–S3 level, resulting in increased osteoblastic activity and radiotracer accumulation outlining the classic H configuration.
Alternative names: H sign, H pattern
Other associated named signs: None
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