Presentation
Intermittent headaches, right shoulder pain, thoracolumbar and lumbosacral discomfort after extended periods of standing.
Patient Data
These images demonstrate three (3) metallic artefacts:
- female gonadal shield
- left side marker
- umbilical ring body piercing
These 'artefacts' should not distract you from observing a number of anomalous radiographic findings including:
- bilateral hypoplastic transverse processes at L4
- L5/S1 zygapophyseal joint tropism (the joint plane is normally coronal and therefore not visible on an AP view)
- Schmorl nodes at T12 (large)
- Limbus vertebra at L3
The cervical images were obtained at the same time as the lumbopelvic images. These demonstrate cervical ribs and reversal of the normal lordotic curvature.
Case Discussion
The presence of the umbilical ring is of incidental note in this case.
A number of postural deviations from normal are evident, including the increased lumbar spine lordosis, the shallow kyphosis in the cervical spine, and the mild left lateral list of the lumbar spine.
More significant clinically are the bilateral cervical ribs, the Schmorl node at T12 and the L3 limbus vertebra.