Young athletes with low back pain: skeletal scintigraphy of conditions other than pars interarticularis stress.
OBJECTIVE
Skeletal scintigraphy is an important method for showing evidence of stress injuries affecting the partes interarticulares of young athletes with low back pain. Other etiologies of low back pain may also cause uptake abnormalities in these patients. How often do the results of skeletal scintigraphy support diagnoses other than stress injuries to the partes interarticulares and what are these diagnoses?


METHODS
We retrospectively reviewed the records of 209 young patients (149 females, 60 males; age range: 8-21 years, mean: 15.7 years) with low back pain and no previously treated vertebral condition who were consecutively referred from a sports medicine clinic to skeletal scintigraphy.


RESULTS
Sites of high uptake supportive of diagnoses other than pars interarticularis stress were shown in 36 (17%) of the 209 patients. Other diagnoses supported by skeletal scintigraphy included stress at the articulation between a transitional vertebra and the sacrum, injuries to the vertebral body ring apophysis, sacral fracture, spinous process injury, and sacroiliac joint stress.


CONCLUSIONS
Skeletal scintigraphy shows uptake abnormalities supportive of diagnoses other than pars interarticularis stress in a significant number of young patients with low back pain. The uptake abnormalities shown are usually stress-related in this select population.
Division of Nuclear Medicine, Children's Hospital, Boston, Massachusetts 02115, USA. Leonard.connolly@childrens.harvard.edu
Leonard P
LP
Connolly
Laura A
LA
Drubach
Susan A
SA
Connolly
S Ted
ST
Treves
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D015775:Fractures, Stress / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012447:Sacrum / Q000293:injuries; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging*; D013669:Technetium Tc 99m Medronate; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate