Fractured ossified iliolumbar ligament

Case contributed by Hazem M Almasarei


Female patient complaining of low back pain more on the right side, duration of 31 days, mainly during sitting.

Patient Data

Age: 30 years
Gender: Female

Four lumbar type vertebral bodies (lumbosacral transitional vertebra: sacralization of L5).

Fracture involving the right ossified iliolumbar ligament.

Annotated image

Annotated image showing fracture of the right ossified iliolumbar ligament.

Case Discussion

Iliolumbar ligament originated from the transverse process of L5 and inserted deep into the ventral margin of the iliac crest. Its main function is to strengthen the lumbosacral joint. 

The Iliolumbar ligament can be calcified or ossified and the differential diagnosis includes:

  • normal variant
  • degenerative changes
  • diffuse idiopathic skeletal hyperostosis
  • ankylosing spondylitis
  • metabolic e.g. hypoparathyroidism

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