Presentation
Three-year history of low back pain, worsening for the past 1 month.
Patient Data
Mildly enlarged and retroverted uterus. Thinning of the lower anterior uterine wall with focal triangular discontinuity of the myometrium suggestive of a cesarean scar niche.
Reduced L5/S1disc height with disc desiccation and fissuring, adjacent subchondral cyst as well as end plate signal changes. Mild bilateral neural foraminal narrowing.
Mild L3/L4 disc desiccation with annular fissure.
Case Discussion
Lumbar spine MRI was done for this patient due to low back pain. Incidental findings of mildly enlarged uterus with lower anterior uterine wall discontinuity, suggestive of a cesarean scar niche.
The causes of cesarean scar niche may be due to poor healing secondary to technical (low incision), anatomical (retroflexed uterus) or patient factors (BMI, maternal age, smoking) 1.
Patients may present with pain, post-menstrual or dysfunctional bleeding, and subfertility. When pregnant, they may be at risk of abnormal placental adherence or uterine rupture. They may also be asymptomatic.
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