Acute pars interarticularis stress response
Low back pain for months.
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Bone marrow edema centered on the L5 pars interarticularis bilaterally without a definite complete low T1 fracture line. Minimal anterolisthesis of L5 on S1. Bilateral L5/S1 facet joint effusions with adjacent soft tissue inflammatory change.
This is the acute imaging appearance of stress response in the pars interarticularis without a definite established fracture. Whether a complete fracture has occurred can be difficult to assess on routine MRI sequences. CT is generally helpful in this area although 3 T MRI with thin-slice T1 VIBE sequence has been shown to have comparable accuracy.
- Ang EC, Robertson AF, Malara FA, O'Shea T, Roebert JK, Schneider ME, Rotstein AH. Diagnostic accuracy of 3-T magnetic resonance imaging with 3D T1 VIBE versus computer tomography in pars stress fracture of the lumbar spine. (2016) Skeletal radiology. 45 (11): 1533-40. doi:10.1007/s00256-016-2475-7 - Pubmed