Penn State Milton S. Hershey Medical Center, USA
Alina Wang graduated from Hofstra University in Hempstead, NY, with a Bachelor of Science in Biology with a minor in Chemistry. She obtained an MBA in Health Care Management from Davenport University, based in Grand Rapids, MI. She obtained her MD from the University of Medicine and Health Sciences in St Kitts, West Indies. She is currently a second-year resident in the Department of Family and Community Medicine of Penn State Milton S. Hershey Medical Center, based in Hershey, PA.
An 18-year-old male volleyball player presented to the sports medicine clinic for evaluation of a 3-week history of low back pain, beginning on the right, with recent involvement of the left side. The patient reported feeling pain in his right lower back whenever he landed or blocked. Physical examination demonstrated mild pain located on the right and left side (paravertebral), and on palpation of the vertebra in the proximal lumbar spine. Paraspinal spasms were also present. No symptoms suggested an inflammatory etiology. Remaining results of the physical examination, including results of neurologic tests, were within normal limits. The patient was referred for conventional lateral radiography of the lumbar spine, which showed limbus vertebra. The patient received conservative treatment. There have been few documented case reports of this type of condition in patients within this age group. Proper diagnosis is essential in order to select appropriate treatment and prevent chronic refractory pain. Limbus vertebra could be mistaken for a fracture, discitis, Schmorl's node or tumor resulting in further unnecessary, even invasive diagnostic procedures.