Presentation
Sinus tract in abdominal wall
Patient Data
12th rib hypoplastic on left side.
Sacralization of L5 vertebra on left side, with pseudoarthrosis and periarticular sclerosis.
Small metallic objects over left flank and lower abdomen.
Case Discussion
These are incidental findings in this patient presenting with an unrelated pathology, i.e. a sinus tract in the abdominal wall. Both the hypoplastic 12th rib and the sacralized L5 vertebra are considered to be normal variants.
The 12th rib is an atypical rib, and is seen on medical images in a variety of presentations, ranging from aplasia to hypoplasia, both unilateral and bilateral.
Sacralization of L5 vertebra occurs by articulation and ultimately1 fusion of its transverse processes with the ala of the sacrum, and is seen in both unilateral and bilateral forms. Unilateral fusion, as in this case, may produce asymmetry in the transmission of weight/stress along the vertebral column, which is reflected by the periarticular sclerosis.1
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