A 16-year-old gymnast presents with acute central low back pain. Which condition is most likely causing her symptoms?

• A. Herniated disc
• B. Spondylolysis
• C. Muscle strain
• D. Facet joint syndrome

Answer: (B)

The symptoms described in the question—acute central low back pain in a 16-year-old gymnast—are most likely attributed to spondylolysis. Spondylolysis is a common condition among young athletes, particularly those involved in sports that require repetitive hyperextension of the lumbar spine, such as gymnastics.

This condition involves a defect or stress fracture in the pars interarticularis of the vertebral arch, leading to low back pain that can be acute in nature. Given the physical demands of gymnastics, which often include flexibility and strength training that places significant stress on the lumbar region, this population is at an increased risk for developing spondylolysis. The acute presentation of pain further supports this diagnosis, as it often occurs following a specific activity that exacerbates the underlying defect.

In contrast, while a herniated disc could cause similar symptoms, it is less common in this age group and population, particularly without a history of prior trauma or significant degenerative changes. Muscle strains typically present with localized pain following a specific injury or overuse but would not specifically account for the central low back pain characteristic of spondylolysis. Facet joint syndrome might also cause pain in the back, but it generally manifests as more chronic