Lumbosacral Transitional Vertebra Confused with Spondyloarthritis: A Case with Sacroiliac Joint Dysfunction
Year: 2026
Type: article
Study design: Case Report
Abstract: Lumbosacral transitional vertebrae (LSTV) are common congenital anomalies of the spine and are frequently detected incidentally on imaging studies. LSTV may cause inflammatory lower back pain, sacroiliitis, and sacroiliac joint dysfunction. Therefore, its clinical presentation may mimic inflammatory spinal pathologies, leading to diagnostic confusion. A 30-year-old female patient had been receiving treatment for ankylosing spondylitis for 3 years without clinical improvement. Physical examination revealed a positive test of the right sacroiliac joint. Laboratory findings showed no significant abnormalities. Imaging studies demonstrated Castellvi type IV LSTV. Following a right sacroiliac joint injection, the patient’s pain score decreased to 0. LSTV may be a source of lower back pain and can significantly affect the sacroiliac joint. In some cases, lower back pain may present with inflammatory characteristics. The diagnosis of sacroiliac joint-related pathologies is challenging due to complex anatomy, limited sensitivity of imaging findings, and overlapping clinical features with other causes of low back pain, particularly spondyloarthritis. LSTV should be considered in the differential diagnosis of patients presenting with low back or sacroiliac joint pain to avoid misdiagnosis and inappropriate treatment.
Authors: Evren Er, Oruç Keleş
Institution: Giresun University
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7204267146