The supine abdominal x-ray shows severe degenerative changes in the lumbar spine with scoliosis. There is also a curvilinear calcification of the aortic wall seen in the left paraspinal area. The right aortic wall is not visible.

Remember to include abdominal aortic aneurysm as a differential diagnosis in an elderly patient with low back pain. Our patient did not have an aortic aneurysm.

In older individuals, vascular calcification involving the aorta & iliac vessels are common. Aortic aneurysm manifests when the luminal diameter exceeds 3 cm. Bedside ultrasound can be used to screen a patient for aortic aneurysm.

Reference: Brant & Helms Fundamentals of Diagnostic Radiology, 5th Edition.