Presentation
Handball player with back problems.
Patient Data
Age: 30 years
Gender: Male
From the case:
Retroisthmic cleft of the vertebral arch
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Continuous dark sclerotic line in the right L5 vertebral arch with osteophytes, dorsal to the isthmus. This patient also had bilateral spondylolysis with minimal spondylolisthesis.
Case Discussion
Retroisthmic clefts are the least common of six types of posterior vertebral arch defects (including persistent fusion anomalies):
Other than isthmic spondylolysis, it lies dorsal to the inferior articular facet. Stress fracture from repetitive trauma is the most probable cause 1.
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