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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Radiology

Background:

  • Adolescent back pain is a common concern, particularly in athletes.
  • Stress fractures are often suspected in young athletes with activity-related back pain.

Observation:

  • A 14-year-old gymnast presented with escalating lower thoracic back pain.
  • Physical examination identified localized tenderness around the T10 vertebral level.
  • A bone scan revealed focal radiotracer uptake adjacent to the midline.

Findings:

  • Combined interpretation of bone scan and spinal computed tomography (CT) confirmed apophysitis of the transverse process.
  • This condition involves inflammation of the apophysis, a bony outgrowth.

Implications:

  • Apophysitis of the transverse process is an uncommon etiology of back pain in adolescent athletes.
  • Accurate diagnosis requires integrating imaging findings, especially when differentiating from stress fractures.
  • Recognition of this rare cause is important for appropriate treatment and return-to-sport protocols.