HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Connolly, L. P. Articles by Treves, S. T. Search for Related Content PubMed PubMed Citation Articles by Connolly, L. P. Articles by Treves, S. T.

Skeletal Scintigraphy of Young Patients with Low-Back Pain and a Lumbosacral Transitional Vertebra

¹ Division of Nuclear Medicine, Department of Radiology, Children’s Hospital, Boston, Massachusetts
² Department of Orthopedics, Children’s Hospital, Boston, Massachusetts

View larger version (157K): [in a new window]   FIGURE 1. (A) Transitional vertebra is shown on radiograph of 17-y-old girl with 7-mo history of progressive low-back pain that was exacerbated with hyperextension. Sclerosis is not evident along articulation of right transverse process with sacrum, which is denoted by arrows. (B) No focal uptake abnormality is demonstrated by posterior (left) and anterior (middle) planar images from skeletal scintigraphy, but SPECT (axial [top right] and coronal [bottom right] images) shows high uptake at transverse-sacral articulation (arrows).

View larger version (88K): [in a new window]   FIGURE 2. (A) Skeletal scintigram shows high uptake at left-sided transverse-sacral articulation (arrows) of 17-y-old female athlete who had been experiencing low-back pain for 2 y. Abnormality is shown better on anterior (middle) than posterior (left) planar image and is seen better still on SPECT images (axial [top right] and coronal [bottom right]). (B) Radiography findings had been interpreted as normal for this patient, perhaps because bowel gas and contents obscured transverse-sacral articulation, which was clearly shown (arrows) on repeated radiographs (C) after skeletal scintigraphy. Bone along medial margin of transverse-sacral articulation appears sclerotic. Axial (D) and coronal (E) reformatted CT images show cystic changes and sclerosis on either side of transverse-sacral articulation, which is indicated by arrow.

View larger version (101K): [in a new window]   FIGURE 3. (A) Radiograph of 15-y-old girl with extension-based low-back pain shows sclerosis along left-sided transverse-sacral articulation (arrows). (B) Posterior (left) and anterior (middle) planar images and SPECT (axial [top right] and coronal [bottom right] images) show high uptake (arrows) along articulation. (C) Coronal T1-weighted MRI after gadolinium shows enhancement (arrows) indicating marrow edema on each side of articulation.