Stress reactions involving the pars interarticularis in young athletes

Am J Sports Med. 1981 Sep-Oct;9(5):304-12. doi: 10.1177/036354658100900504.

Abstract

A stress reaction involving the pars interarticularis of the lumbar spine was confirmed in seven young athletes with a positive technetium pyrophosphate bone scan. No pars defects were detectable on their lumbosacral roentgenograms, which included oblique views. The return to normal levels of radioactive uptake on repeat bone scans correlated closely with their clinical course. If the bony reaction is recognized early, it may heal at a subroentgenographic level and prevent the development of lumbar spondylolysis. These early lesions usually show unilateral increased uptake at one lumbar level on the bone scan and, initially, the athlete localizes the pain to the corresponding unilateral lumbar paraspinous area. The "one-legged hyperextension test" is positive on the ipsilateral side and aggravates the pain. Treatment consists of avoiding the aggravating activities and resting. The average time for return to pain-free competition was 7.3 months. These developing defects may be the source of considerable prolonged disability in the young athlete, particularly if undiagnosed and untreated.

MeSH terms

  • Adolescent
  • Adult
  • Athletic Injuries / diagnostic imaging*
  • Athletic Injuries / therapy
  • Back Pain / etiology*
  • Back Pain / therapy
  • Child
  • Diphosphates
  • Female
  • Humans
  • Immobilization
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / injuries*
  • Male
  • Prospective Studies
  • Radionuclide Imaging
  • Rest
  • Stress, Physiological / complications*
  • Technetium
  • Technetium Tc 99m Pyrophosphate

Substances

  • Diphosphates
  • Technetium Tc 99m Pyrophosphate
  • Technetium