Table 5.

Differential Diagnoses of Lumbar Spondylolisthesis in the Sagittal Plane and Appropriate Imaging.

	Plain Radiography	Magnetic Resonance Imaging	Computed Tomography (CT)	CT Myelography
Lumbar Spondylolisthesis	Upright, weight bearing lateral lumbar view is most appropriate for detecting spondylolisthesis.[71] Lateral lumbar flexion and extension views may demonstrate lumbar instability.[72]	Most appropriate for imaging spinal stenosis or facet joint effusion. [71] Provides a detailed view of the lumbar spine, conus medullaris, and soft tissue structures.[72]	Useful when MRI and CT myelography are contraindicated or inconclusive. Useful in assessing spinal stenosis or nerve roots and provides a detailed view of the facet joints.[71,72]	Useful in assessing spinal stenosis or nerve roots and when MRI is contraindicated or inconclusive. [71] Provides a view of the entire lumbar spine and is done in the standing position (accentuates spinal stenosis).[72]
Lumbar Compression Fracture	Upright, weight bearing lateral lumbar view is most appropriate for detecting spondylolisthesis.[71] Lateral lumbar flexion and extension views may demonstrate lumbar instability.[72]
Lumbar Canal Stenosis		Most appropriate for imaging spinal stenosis or facet joint effusion. [71] Provides a detailed view of the lumbar spine, conus medullaris, and soft tissue structures.[72]	Useful when MRI and CT myelography are contraindicated or inconclusive. Useful in assessing spinal stenosis or nerve roots and provides a detailed view of the facet joints. [71,72]	Useful in assessing spinal stenosis or nerve roots and when MRI is contraindicated or inconclusive. [71] Provides a view of the entire lumbar spine and is done in the standing position (accentuates spinal stenosis).[72]
Lumbar Disc Herniation		Most appropriate for imaging spinal stenosis or facet joint effusion. [71] Provides a detailed view of the lumbar spine, conus medullaris, and soft tissue structures.[72]
Lumbar Facet Arthropathy		Most appropriate for imaging spinal stenosis or facet joint effusion. [71] Provides a detailed view of the lumbar spine, conus medullaris, and soft tissue structures.[72]	Useful when MRI and CT myelography are contraindicated or inconclusive. Useful in assessing spinal stenosis or nerve roots and provides a detailed view of the facet joints.[71,72]
Lumbar Spondylolysis	Upright, weight bearing lateral lumbar view is most appropriate for detecting spondylolisthesis.[71] Lateral lumbar flexion and extension views may demonstrate lumbar instability.[72]