Learning objectives
To identify facet joint pathologies that can cause low back pain.
Background
While lumbar magnetic resonance imaging (MRI) is interpreted with the preliminary diagnosis of low back pain, the largest share is given to the discs. Facet joint pathologies, which may cause low back pain, can be overlooked in centers where too many scans are performed as ours. However, facet joints and surrounding structures have rich innervation and may cause pain due to physical injury or release of inflammatory mediators [1]. The lumbosacral facet joint is reported to be the most common source of mechanical low back...
Findings and procedure details
Common facet joint pathologies that can cause low back pain:
Facet Joint Hypertrophy/Arthrosis
Facet joints are potential source of pain in low back pain and its prevalence increases with age. The highest prevalence of facet joint osteoarthritis is in L4–L5 spinal level [3]. Possible risk factors for facet joint osteoarthritis include sex, genetic predisposition, ethnicity, body composition (overweight), occupation (sedentary work, lifting of heavy objects), nutritional and lifestyle factors [4].
Hypertrophic changes in the facet joints and arthrosis result in narrowing of the spinal canal,...
Conclusion
Keeping in mind that facet joint pathologies are an independent or contributing cause of pain in patients with chronic low back pain, will be useful for radiologists.
Personal information and conflict of interest
R. E. Özkan; Istanbul/TR - nothing to disclose H. Kurtul Yıldız; Istanbul/TR - nothing to disclose
References
[1] Igarashi A, Kikuchi S, Konno S, (2004) Inflammatory cytokines released from the facet joint tissue in degenerative lumbar spinal disorders. Spine 29: 2091-2095.
[2] Markwalder TM., Mérat M., The lumbar and lumbosacral facet-syndrome. Diagnostic measures, surgical treatment and results in 119 patients, Acta Neurochirurgica, March 1994, Volume 128, Issue 1, pp 40-46. Level of evidence 2B
[3] Kalichman, L., Li, L., Kim, D. H., Guermazi, A., Berkin, V., OʼDonnell, C. J., … Hunter, D. J. (2008).Facet Joint Osteoarthritis and Low Back Pain in the...