A 14-Year-Old Previously Healthy Girl Is Evaluated for a 3-Month

A 14-year-old previously healthy girl is evaluated for a 3-month history of low back pain.  She is a member of her school gymnastics team, and the pain is worse after training sessions.  The patient reports no significant back trauma and has had no weakness or numbness in the lower extremities.  Menarche was at age 9 and she has had regular menstruations.  Vital signs are within normal limits.  Physical examination shows tenderness in the L5 region, but no neurologic deficits are present.  A spine x-ray reveals anterior displacement of L5 vertebra relative to the S1 vertebra.  This patient's condition is most likely caused by injury to which of the following structures?

A) Intervertebral disc
B) Pars interarticularis
C) Spinous process
D) Transverse process
E) Vertebral body

Correct Answer:

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