Fig. 3

A 67-year-old woman with an insufficiency fracture of the L3 transverse process. a Lateral view of radiograph showing an L2 spondylolisthesis after posterior lumbar interbody fusion of L3/4, with adjacent spinal degenerative disease considered the cause of pain based on pain location and imaging assessment using plain radiographs, computed tomography, and magnetic resonance imaging. b Bone SPECT/CT image showing a hotspot in the right transverse process of L3, and not in the facet joint of L2/3. c On retrospective review of the computed tomography image, the non-traumatic insufficiency fracture of the right transverse process of L3 was identified (black arrow), and the patient was treated using oral steroids for rheumatoid arthritis. d T2-weighted MR axial image without findings indicating the insufficiency fracture of the right transverse process of L3. MR, magnetic resonance; SPECT/CT, bone scintigraphy with single photon emission computed tomography