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We report the positron emission tomography-computed tomography appearance of Baastrup disease in the L2–L5 interspinous ligament region in a 79-year-old woman with a history of moderately differentiated lobular breast carcinoma. The patient is status post bilateral mastectomies, on tamoxifen for 2 and a half years, and currently in remission. Baastrup disease is characterized by close approximation and contact of adjacent spinous processes with resultant enlargement, flattening, and reactive sclerosis of apposing interspinous surfaces. Knowledge of the appearance of Baastrup disease on fluorodeoxyglucose positron emission tomography-computed tomography is important to avoid confusion with a spinous process lesion.