Acute L3 Spondylolysis with Venous Epidural
Joseph Junewick, MD FACR
over 3 years ago
Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.
Heather Borders, MD
|Diagnostic Category: Trauma
|Created: over 4 years ago
|Updated: over 4 years ago
Two different patients:
Radiograph history is right hip pain after a soccer injury.
MRI history is right hip pain after several episodes of a “pulled muscle.”
CR-Crescentic nondisplaced avulsed fragment of bone at the AIIS
MRI-Crescentic fragment of mildly displaced bone at the level of the AIIS with adjacent inflammation, periosteal reaction and edema.
Avulsion injury at the AIIS occurs due to traction by the rectus femoris muscle. The injury can be acute or chronic.
Chronic injury results in reparative new bone formation and can be mistaken for a more aggressive process.
These injuries occur at typical locations and are common in adolescents and attempt should be made not to mistake this for a more aggressive process.
Acute-radiographically, an avulsed fragment of bone with variable degrees of displacement. If injury is non-osseous a fragment may not be visible radiographically. MRI shows similar findings to radiographs with a variable amount of associated edema. MRI demonstrates associated musculotendinous and cartilaginous injury.
Correlation with radiographs should always be performed when interpreting the MRI to help avoid mistaking an avulsion for a more aggressive process.
Chronic-healing with variable degrees of callus and new bone depending on the degree of displacement. If initial injury was cartilaginous, periosteal new bone/reparative change may be the only finding.
Caffey, pediatric imaging. pp. 2796-2797.
Greenspan, orthopedic imaging pp. 222-224.