Bertolotti’s Syndrome with type II A Castellvi classification.

PROTOCOL:   T1W & T2W - Sagittal & Axial scans

FINDINGS:

-There is normal lumbar lordotic curvature.

-Enlarged L5 left transverse process with formation of a unilateral diarthroidal joint between it and the sacrum (Castellvi classification type II A).
-Grade I spondylolisthesis of L4 over L5.
-The intervertebral disc show abnormal hyperintense signal on T2W scans. 
L4-5: Diffuse disc bulge causing mild thecal indentation with bilateral mild foraminal encroachment.
L3-4: Diffuse disc bulge causing mild thecal indentation with mainly left foraminal encroachment.

-No other significant focal protrusion or diffuse disc bulge is noted.
-Spinal canal dimensions are adequate.
-Facet joints and ligamentum flava show normal signal intensity.
-Thecal sac, conus and cauda equina are normal in appearance.
-Paravertebral muscles show normal MR morphology and signal intensity.


IMPRESSION

• Bertolotti’s Syndrome with type II A Castellvi classification.
• Degenerative disc disease with disc lesion as mentioned          above for clinical correlation.

Reported By : DR.MOHAMMED MOHYELDIN
 Consultant-Radiologist