Baastrup’s disease is characterized by close approximation and abutment of spinous processes, interspinal bursitis, interspinous ligament degeneration/tears, subcortical cysts/erosions, edema, chondroid metaplasia, enchondral ossification involving opposing spinous processes, creation of synovial articulations, and occasionally the development of epidural cysts or epidural fibrotic masses Interspinous bursitis can communicate with Baastrup’s associated epidural cysts, the facet joints(leads to a classic butterfly appearance), as well as pars interarticularis defects.
Fluid within the retrodural space of Okada dorsal to the ligamentum flavum (blue arrow), extending into the bilateral facet joints and posteriorly into an interspinous bursa.
The fluid creates a “Y”- or wishbone-shaped configuration.
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