Case 29 Answer

- So did you think rugger-jersey spine? Although that is far more common and can look similar, the sclerosis here is way too dense and way too thick. This is an example of the so called “sandwich vertebrae” of Osteopetrosis.

But that alone doesn’t necessarily cause pain does it? Their bones are VERY dense but ironically are very fragile so always look hard for the fracture. Where is the fracture here?

Answer: Osteopetrosis with bilateral L5 pars interarticularis defects and anterior spondylolithesis of L5 on S1

reference: https://radiopaedia.org/articles/autosomal-dominant-osteopetrosis

https://radiopaedia.org/articles/spondylolysis