STUDY DESIGN: A case report and literature review is presented.
OBJECTIVE: To review relevant data for the management of Bertolotti's syndrome 
and to determine whether the transverse process-ilium articulation may be a pain 
generator.
BACKGROUND: Bertolotti's syndrome is associated with axial low back pain 
secondary to arthritic changes; the pain generator in the disorder is unclear.
METHODS: We present a case report of symptomatic Bertolotti's syndrome managed 
with intra-articular steroid injections.
RESULTS: A patient with Bertolotti's syndrome had significant relief of axial 
pain after steroid injection of the ilium-transverse process articulation.
CONCLUSIONS: Steroid therapy may be a non-surgical alternative for the treatment 
of symptomatic Bertolotti's syndrome.