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Rheumatology Advance Access originally published online on October 18, 2005
Rheumatology 2006 45(2):209-211; doi:10.1093/rheumatology/kei134
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Degenerative spondylolysis: a concise report of scintigraphic observations

H. Van der Wall, M. Magee, L. Reiter1, C. J. Frater4, S. Qurashi2 and R. Loneragan3

Departments of Nuclear Medicine, 1 Rheumatology, 2 Orthopedics and 3 Radiology, Concord Hospital and 4 University of Sydney, Sydney, Australia.

Correspondence to: H. Van der Wall, Department of Nuclear Medicine, Concord Hospital, Hospital Road, Concord 2139, Australia. E-mail: hansv{at}nmrf.org.au

Objectives. Spondylolysis is traditionally thought to be a diagnosis of adolescence and childhood, and is ascribed to mechanical stress through the immature pars interarticularis. Over the last 4 yr we have noted a presentation of spondylolysis in association with hypertrophic zygapophyseal joint disease in the lumbar spine in an older age group.

Methods. Records of 94 patients presenting with low back pain were examined. A pattern of intense zygapophyseal joint uptake in association with extended uptake in the pars interarticularis was ascribed as degenerative spondylolysis.

Results. The ages of the 94 cases ranged from 33 to 80 yr (mean 64 yr). There were 53 males and 41 females. In the group with degenerative spondylolysis the mean age was 72 yr, with four females and two males. None of these six patients gave a history of childhood spinal disease or back pain and all were relatively inactive in terms of current participation in sport. All cases of spondylolysis were confirmed by computed tomography scanning.

Conclusion. The finding of hypertrophic zygapophyseal joint disease in association with spondylolysis is easily recognized by scintigraphic tomographic imaging.

KEY WORDS: Scintigraphy, Degenerative spondylolysis, Fracture, Facet joint


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