Case 12
History:
58 year old male with back pain of one year duration radiating to the lower limbs, left more than right
Findings:
Sagittal CT reconstruction of the lumbar spine showing enlarged spinous processes of all lumbar vertebrae which were seen opposing each other on extension views. Mild sclerosis as well as erosions is seen at the opposing areas of the spinous processes.
Diagnosis:
Baastrup's Disease
Discussion:
Baastrup’s disease (Christian Baastrup, 1885 – 1950, Danish radiologist) is a well-documented disease that is characterized by close approximation and contact of adjacent spinous processes (kissing spine) with resultant enlargement, flattening, and reactive sclerosis of apposing interspinous surfaces.
Clinically as midline localized lumbar tenderness and pain on back extension that can be relieved by flexion, local anesthetic injection, and excision of part of the spinous processes.
Radiographically, characterized by close approximation and contact of the adjacent spinous processes (kissing spines) and enlargement, flattening and reactive sclerosis of apposing interspinous surfaces. MRI of the lumbar spine can clearly depict Baastrup’s disease, interspinous bursal fluid, and an associated posterocentral epidural cyst.
References:
- L.J. Michotte. Le syndrome des epineuses. Revue du rhumatisme et des maladies osteo- articulaires, Paris, 1949, 16: 249-251.
- C.I. Baastrup: Proc.spin. vert.lumb. und einige zwischen diesen liegenden Gelenkbildungen mit pathologischen Prozessen in dieser Region. Fortsschritte auf dem Gebiete der Rontgenstrahlen, 1933, 48:430-435.
- Brailsford JF. Deformities of the lumbosacral regions of the spine. Br J Surg 1929; 16: 562-627.
- Hazlett J. Kissing spines. J Bone Joint Surg Br 1964: 46: 1368-1369
