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Observations
There is a thin vertical linear lucency through the body of the L2 left transverse process with mild displacement. Vertebral bodies and pedicles appear normal.

Diagnosis
This patient sustained an acute L2 transverse process fracture. Such injuries occur most commonly in the upper lumbar spine and are often multiple. Further, approximately 35% of patients with lumbar transverse process fractures have hepatic and splenic injuries, as well as genitourinary and diaphragmatic injuries.

It is important to note that up to 60% of lumbar transverse process fractures identified on CT will have been missed on plain radiographs. As such, CT is recommended for any patient whose examination and mechanism of injury raise suspicion for transverse process fracture.

Back Pain After Falling from a Ladder
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