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. Nor 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 courseIf the bony reaction is recognized early, it may heal at a subroentgenographiclevel and prevent the development of lumbar spondylolysis. These early lesionsusually show unilateral increased uptake at one lumbar level on the bone scan and, initially, the athlete localizes the pain to the corresponding unilaterallumbar 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 painfree competition was 7.3 months. These developing defects may be the source ofconsiderable prolonged disability in the young athlete, particularly if undiagnosed and untreated. Verf.-Referat