Presentation
Chronic low back pain and morning stiffness. Poor response to conservative measures. No significant past medical history.
Patient Data
Age: 18 years
Gender: Female
From the case:
Bilateral L4 pars defects
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Bilateral undisplaced L4 pars defects. Fatty signal in both pedicles compatible with a chronic stress reaction.
Noncompressive L5/S1 central disc protrusion.
No neural compression.
No other significant finding.
From the case:
Bilateral L4 pars defects
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Earlier radiograph confirms L4 pars defect. Mild anterolisthesis of L4 on L5 (not replicated on MRI).
Case Discussion
MRI and XR of bilateral L4 pars defects. Fatty change in the pedicles indicates a longstanding stress process i.e. the defects are unlikely to be acute abnormalities in this patient.