Abstract
Low back pain of various etiologies is a common clinical presentation in young athletes. In this article, we discuss the utility of SPECT/CT bone scintigraphy for the evaluation of low back pain in young athletes. The spectrum of lower spine lesions caused by sports injuries and identifiable on bone scan is presented along with strategies to avoid unnecessary irradiation of young patients. Also covered are pitfalls in diagnosis due to referred-pain phenomenon and normal skeletal variants specific to this age group.
Highlights
The etiology of low back pain in young athletes differs from that seen in adults, with bony etiology being more common than disc-related disease [1,2]
MRI is preferred if neurologic symptoms are present or if radicular pain is identified on clinical exam
Lumbar spine origin of low back pain Spondylolysis Isthmic spondylolysis represents a pars interarticularis fracture usually associated with repetitive forced hyperextension and rotation
Summary
The etiology of low back pain in young athletes differs from that seen in adults, with bony etiology being more common than disc-related disease [1,2]. Chronic low back pain occurs more often than acute pain and is caused by repetitive microtrauma due to flexion, extension, and rotation movements that increase the risk of injury to the posterior elements of the spine. The initial evaluation of a young adult with back pain starts with lumbar spine radiograph; this has limited sensitivity in the detection of pars fractures and stress reactions.
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