Case Of the Week (COW) 10 Feb 2013
Answer:
Bertolotti Syndrome.
Findings:
Transitional Lumbosacral junction (Sacralization of L5) is seen. Abnormal STIR hyperintensities are noted in the elongated L5 transverse process and adjoining articular surface of sacrum.
Discussion:
The lumbosacral transitional vertebra are congenital spinal anomalies defined as either sacralization of the lowest lumbar segment or lumbarization of the most superior sacral segment of the spine. The lumbosacral transitional vertebra have been classified by Castellvi into four types Bertolotti Syndrome is the Association of back pain with lumbosacral transitional vertebrae Anomalous enlargement of the transverse process of the lowermost lumbar vertebra with fusion with the sacrum or ilium The Pain is related to arthritis at the pseudoarticulation or the facets or disc disease at the level above the pseudoarticulation The pain in our patient is likely due to the arthritis at the Pseudoarticulation.
Ref: Lumbosacral Transitional Vertebrae: Classification, Imaging Findings, and Clinical Relevance AJNR 2010 31: 1778-1786
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai
Answer:
Bertolotti Syndrome.
Findings:
Transitional Lumbosacral junction (Sacralization of L5) is seen. Abnormal STIR hyperintensities are noted in the elongated L5 transverse process and adjoining articular surface of sacrum.
Discussion:
The lumbosacral transitional vertebra are congenital spinal anomalies defined as either sacralization of the lowest lumbar segment or lumbarization of the most superior sacral segment of the spine. The lumbosacral transitional vertebra have been classified by Castellvi into four types Bertolotti Syndrome is the Association of back pain with lumbosacral transitional vertebrae Anomalous enlargement of the transverse process of the lowermost lumbar vertebra with fusion with the sacrum or ilium The Pain is related to arthritis at the pseudoarticulation or the facets or disc disease at the level above the pseudoarticulation The pain in our patient is likely due to the arthritis at the Pseudoarticulation.
Ref: Lumbosacral Transitional Vertebrae: Classification, Imaging Findings, and Clinical Relevance AJNR 2010 31: 1778-1786
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai