Acute pars interarticularis stress response

Case contributed by Dr Henry Knipe


Low back pain for months.

Patient Data

Age: 15 years
Gender: Male

Bone marrow edema centered on the L5 pars interarticularis bilaterally without a definite complete low T1 fracture line. Minimal anterolisthesis of L5 on S1. Bilateral L5/S1 facet joint effusions with adjacent soft tissue inflammatory change. 

Case Discussion

This is the acute imaging appearance of stress response in the pars interarticularis without a definite established fracture. Whether a complete fracture has occurred can be difficult to assess on routine MRI sequences. CT is generally helpful in this area although 3 T MRI with thin-slice T1 VIBE sequence has been shown to have comparable accuracy. 

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Case information

rID: 59106
Published: 21st Mar 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included