Delayed bone scintigraphy, anterior and posterior images
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View second image(bs). SPECT axial and coronal images at L5
View third image(xr). Lateral and bilateral oblique radiolgraphs at L5
Full history/Diagnosis is available below
Spondylolysis is usually diagnosed with radiographs of the lumbar spine. Oblique views which show the "scottie dog" are helpful. Bone scintigraphy shows increased uptake at the pars defect. In the early stages of spondylolysis, bone scintigraphy demonstrates a poorly defined, slightly increased activity that occurs when rapid osteoclastic resorption exceeds the osteoblastic response). In addition, contralateral uptake in a unilateral pars defect probably represents a physiological response or stress fracture in the presence of an unstable neural arch. The intensity of uptake depends upon the degree of bone repair. Absence of uptake can be seen in old or stabilized, nonsymptomatic pars defects. SPECT is superior to planar imaging for detection and accurately localizing vertebral arch abnormalities.
Reference: Resnick D: Bone and Joint Imaging. Philadephia, WB Saunders Co, 1996.
References and General Discussion of Bone Scintigraphy (Anatomic field:Spine and Contents, Category:Effect of Trauma)
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