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Case 28-Non-specific lower back discomfort.


47 yo/female presents complaining of non-specific lower back discomfort. No prior red flags.

   What do you see?


The AP view of the lumbar spine shows a curvi-linear density superimposed on the proximal sacrum. The latearal view shows the cyst/mass like density to be intra-peritoneal in location which measured 9.3 cm. in transverse dimension on initial x-ray interpretation. Mild spondylosis is present at L3 & 4. A diagnostic US of the pelvis was ordered.


Uterine fibroids are synonymous with uterine leiomyomas or myomas.

Approximately 20-30 % of females of reproductive age  will develop this most common gynecologic tumor.

A patient with a 6.0 pound uterine fibroid (post-surgical specimen) is the author’s most vivid recollection of this condition!

The diagram below shows common locations for uterine based fibroids.

    • The  new FIGO system divides uterine fibroids into 3 major categories based on their predominant location.
        • submocosal
        • other
        • hybrid
        • This recent system allows more uniformity in reporting and surgical planning. (1)

      Ultrasound is the inital investigative modality.

MRI adds further evaluation of enlargement & assessment of submocosal lesions. This tool also helps characterize aggressive lesions from the more common fibroid.




  1. Abdominal Radiology (2021)46:4146-2155  -MRI -based pictorial review of the FIGO classification system for uterine fibroids: 

                                             Case compliments of Dr.Permenter, DC Charlotte, North Carolina.