4 Lumbar Vertebral Bodies

Case Description:

This DXA scan shows 4 lumbar vertebral bodies with the sacrum below and a rib bearing vertebral body above the lumbar spine region of interest. There may be several possibilites when viewing a segmentation issue on a lumbar spine DXA scan.
According to Peel JBMR (1973) 8: 719-723 : 2.1% of individuals have 4 lumbar vertebral bodies with the lowest ribs at T12. 5.3% of individuals have 4 lumbar vertebral bodies with the lowerst ribs at T12. It is also possible, but rare, that the lowest set of ribs is present on L1 (the 13th rib). This is said to occur in approximately 1% of the population (https://radiopaedia.org/articles/lumbar-rib?lang=us#:~:text=Lumbar%20(or%2013th)%20ribs,may%20be%20unilateral%20or%20bilateral). Additional imaging of the entire spine to help with segmentation issues.

Credit:

Sarah L Morgan, MD, RD, CCD, The University of Alabama at Birmingham

References:

• Peel, N.F., et al., Impact of anomalous vertebral segmentation on measurements of bone mineral density. J Bone Miner Res, 1993. 8(6): p. 719-23.
• Izadyar, S., et al., The Effect of the Lumbar Vertebral Malpositioning on Bone Mineral Density Measurements of the Lumbar Spine by Dual-Energy X-Ray Absorptiometry. J Clin Densitom, 2016.
• https://radiopaedia.org/articles/lumbar-rib?lang=us#:~:text=Lumbar%20(or%2013th)%20ribs,may%20be%20unilateral%20or%20bilateral.