{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T08:42:37Z","timestamp":1772613757715,"version":"3.50.1"},"reference-count":9,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>A butterfly vertebra is an uncommon but clinically and radiologically significant pathology. The etiological factor of this pathology is a congenital defect in the formation of the vertebral body during embryogenesis, resulting in a cleft within the vertebral body that, in an X-ray, resembles the shape of a butterfly. Butterfly vertebrae are most often found in the thoracic and lumbar spine and more rarely in the sacral region. The clinical manifestations of this condition do not differ from the symptoms of other diseases, and it may also be asymptomatic. Only the recognition of its characteristic radiologic signs allows for accurate and timely diagnosis, as well as differentiation from other pathological processes such as fractures, metastases, and inflammation. In these cases, magnetic resonance imaging is the first-choice method. An important aspect in recognizing this pathology is its correlation with other congenital syndromes, even in cases of a single vertebral defect. We present 2 cases with an isolated S1 butterfly vertebra. The first is a 47-year-old male who presented to the hospital with complaints of chronic pain in the lower back and sacral region, more pronounced on the right side. The second is of a 39-year-old male who also presented to the hospital with chronic pain. All diagnostic modalities for this pathology have been used to demonstrate high-quality pictures, including X-ray, computed tomography (CT), and magnetic resonance imaging (MRI).<\/jats:p>","DOI":"10.3390\/diagnostics15212775","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:55:22Z","timestamp":1762178122000},"page":"2775","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Two Cases of Singular Sacral S1 Butterfly Vertebra"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7457-1901","authenticated-orcid":false,"given":"Arturs","family":"Balodis","sequence":"first","affiliation":[{"name":"Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia"},{"name":"Department of Radiology, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2893-2829","authenticated-orcid":false,"given":"Roberts","family":"Tumelkans","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cenk","family":"Eraslan","sequence":"additional","affiliation":[{"name":"Radiology Department, Ege University, 35040 Bornova, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1177\/2192568218801016","article-title":"Butterfly Vertebrae: A Systematic Review of the Literature and Analysis","volume":"9","author":"Katsuura","year":"2018","journal-title":"Glob. Spine J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4761","DOI":"10.1016\/j.radcr.2022.09.028","article-title":"A rare incidental finding of an isolated S1 butterfly vertebra: A case report","volume":"17","author":"Bhattarai","year":"2022","journal-title":"Radiol. Case Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"406","DOI":"10.4055\/cios.2015.7.3.406","article-title":"Differentiating between Traumatic Pathology and Congenital Variant: A Case Report of Butterfly Vertebra","volume":"7","author":"Karargyris","year":"2015","journal-title":"Clin. Orthop. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Bulahs, I., Teiv\u0101ne, A., Platk\u0101jis, A., and Balodis, A. (2024). Caudal Regression Syndrome First Diagnosed in Adulthood: A Case Report and a Review of the Literature. Diagnostics, 14.","DOI":"10.3390\/diagnostics14101000"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3601","DOI":"10.1589\/jpts.27.3601","article-title":"Differential diagnosis of multiple vertebral compression: Butterfly vertebrae","volume":"27","author":"Ozaras","year":"2015","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"117","DOI":"10.5603\/FM.a2015.0066","article-title":"Butterfly vertebra. A case report and a short review of the literature","volume":"75","author":"Kapetanakis","year":"2016","journal-title":"Folia Morphol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e995","DOI":"10.1016\/j.wneu.2024.03.009","article-title":"Butterfly Vertebra: A Retrospective Study of 30 Patients","volume":"185","author":"Xie","year":"2024","journal-title":"World Neurosurg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1007\/s43390-020-00050-3","article-title":"Thoracolumbar kyphoscoliotic deformity with neurological impairment secondary to a butterfly vertebra in an adult","volume":"8","author":"Bourghli","year":"2020","journal-title":"Spine Deform."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/S0899-7071(01)00266-2","article-title":"Butterfly vertebra: A case report","volume":"25","author":"Sonel","year":"2001","journal-title":"Clin. Imaging"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/21\/2775\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T14:07:32Z","timestamp":1762178852000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/21\/2775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,31]]},"references-count":9,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["diagnostics15212775"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15212775","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,31]]}}}