Pelvic fractures and sacroiliac joint (SI) diastasis are debilitating injuries which can drastically decrease an individual's functional capacity, and lead to significant morbidity and mortality. In younger, healthier populations, pelvic fractures are usually the result of sudden traumatic forces, such as a motor vehicle collision. Atraumatic pelvic fractures can also occur, and are most commonly due to age related changes and osteoporosis. Even with prompt surgical management, pelvic fractures often result in a host of challenging complications such as disruption of the SI joint with subsequent limitations in mobility and chronic pain. In this case report, we present a novel treatment of SI diastasis, secondary to corticosteroid induced osteoporosis and pelvic fractures. We performed percutaneous bilateral poly-methyl-methacrylate (PMMA) SI joint fusions under CT-guidance. Here we describe a case of bilateral SI joint CT guided percutaneous arthroplasty for osteoporotic SI joint diastasis and pelvic fractures, resulting in a rapid resolution of SI joint pain and restoration of the ability to ambulate in a previously wheelchair-bound patient. This may be of particular benefit in patients who are poor surgical candidates who experience osteoporotic fractures and would be otherwise unable to receive definitive operative management of their pathologic fractures.