Incidental gallstones on lumbar spine radiographs

Case contributed by Bálint Botz
Diagnosis certain

Presentation

Chronic low back pain.

Patient Data

Age: 80 years
Gender: Female

Advanced degenerative changes of lumbar spine can be observed, including vacuum phenomena of the intervertebral discs, and formation of osteophytes. Furthermore a chronic osteoporotic wedge fracture of L3 can be observed with approximately 25% height loss. 

Incidentally, numerous opacities displaying laminated structure can be observed in the right upper quadrant, caused by radioopaque gallstones.

Note is also made of the marked atherosclerosis of the abdominal aorta.

 

Case Discussion

About 15-20% of gallstones contain enough calcium to become radioopaque 1, and can be regularly encountered incidentally on radiographs requested for other purposes in asymptomatic patients. 

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