South African Journal of Sports Medicine· 2026Q3
Case report—Stumped: back pain in a cricketer
- 0citations
- Q3SCImago
- 2026year
Short summary
A 19-year-old fast bowler's chronic back pain, initially suspected to be inflammatory sacroiliitis on MRI, was ultimately diagnosed as bilateral L4-L5 stress fractures (spondylolysis) via CT, leading to a successful conservative management and return to sport.
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Key points
- MRI findings of bilateral sacroiliitis with effusion in a young athlete were initially misleading.
- Computed tomography (CT) ultimately diagnosed bilateral L4 and L5 stress fractures (spondylolysis).
- Conservative management including physiotherapy and technique modification led to a full return to sport.
- Mechanical changes in young athletes can mimic inflammatory conditions on MRI.
AI-generated from the title and abstract; the full text is not read.
Abstract
A 19-year-old collegiate fast bowler presented with chronic low back pain that acutely worsened during a tournament. Examination suggested a mechanical origin, but plain radiographs showed subtle lucency at L5 and bilateral sacroiliac sclerosis. MRI was interpreted as bilateral sacroiliitis with effusion, raising concern for axial spondyloarthropathy. Laboratory tests, including HLA-B27, were unremarkable, and rheumatological evaluation did not support a seronegative spondyloarthropathy. Computed tomography ultimately demonstrated stress fractures with developing spondylolysis at L4 and L5. The player was managed conservatively with physiotherapy, core strengthening, and a phased return to sport, including modification of his bowling technique. Full return to sport was achieved at six months after initial presentation. This case highlights the diagnostic pitfalls of interpreting MRI findings in young athletes, where mechanical changes may mimic inflammatory sacroiliitis. CT remains a valuable adjunct in detecting lumbar stress fractures when MRI findings are equivocal.
The authors' abstract, as published at the source. South African Journal of Sports Medicine, 2026 · DOI ↗
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