Three stress fractures occurring at a single vertebral level in an adolescent baseball player

Most stress fractures of the lumber spine reported in athletes have occurred at the pars interarticularis. The number of stress fractures in a single vertebra is usually one or two. Three stress fractures in a single vertebra are very rare. In the present report, we describe the case of a 17-year-old baseball player who had three stress fractures in a single vertebra at the same time. This patient visited a primary care orthopedic physician with complaining of right side low back pain. MRI and CT were taken, and the physician noted unusual findings. Thus, he was referred to our sports clinic. On CT scan, bilateral pars stress fractures at L3 were obvious. MRI-STIR showed bleeding or edema in broad area near the right pedicle at L3. Sagittal reconstruction CT indicated the right pedicle fracture in addition to the bilateral pars defects. Thus, he was noted to have three stress fractures in a single vertebra (i.e., bilateral pars and right pedicle) at the same time. He stopped a baseball practice with wearing a soft trunk supporter for two months until the low back pain was completely disappeared. Two months after the treatment, only pedicle stress fracture was shown to be osseouly healed.