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The prevalence of lumbar facet joint edema in patients with low back pain

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Abstract

Objective

The objective was to assess the prevalence of lumbar facet joint edema in patients with low back pain.

Materials and methods

Lumbar spine MR examinations (1.5 T) of 145 consecutive patients (87 women, 58 men; mean age 52.8, range 17–94 years) were retrospectively evaluated with regard to the presence of facet joint edema. The MR protocol included sagittal short-tau inversion recovery (STIR), T1- and T2-weighted as well as transverse T2-weighted images. In 9 patients follow-up MR examinations were performed and results were compared with pain. The agreement between the change in intensity of facet joint edema and the change in intensity of pain was assessed using kappa statistics and Kendall’s tau coefficient.

Results

In 21 of the 145 patients (14%) edema was found at the facet joints: in 52.4% at L4/5, in 19.0% at L5/S1, in 14.3% at L4/5 and L5/S1, in 9.5% at L3/4 and L4/5, and in 4.8% at L3/4. The agreement between the change in pain score and intensity of edema within the follow-up group was “almost perfect” (kappa = 0.81). Kendall’s tau coefficient was 0.91, indicating high agreement.

Conclusion

Sagittal STIR images detect facet joint edema in 14% of patients with low back pain. This fact may be useful for planning treatment including facet joint injections.

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References

  1. Papageorgiou A, Croft P, Ferry S, Jayson M, Silman A. Estimating the prevalence of low back pain in the general population: evidence from South Manchester back pain survey. Spine 1995;20: 1889–1894.

    Article  PubMed  CAS  Google Scholar 

  2. Statistiska Centralbyran S. Undersökningar av levnadsförhallanden ULF. In: SCB, 1996.

  3. Norlund A, Waddell G. Cost of back pain in some OECD countries. Philadelphia: Lippincott Williams & Wilkins, 2000: 421–425.

    Google Scholar 

  4. Savage R, Whitehouse C, Roberts N. The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males. Eur Spine J 1997;6: 106–114.

    Article  PubMed  CAS  Google Scholar 

  5. Boden S, Davis D, Dina T, Patronas N, Wiesel S. Abnormal magnetic resonance scans of the lumbar spine in asymptomatic subjects. J Bone Joint Surg Am 1990;72: 403–408.

    PubMed  CAS  Google Scholar 

  6. Stadnik T, Lee R, Coen H, Neirynck E, Buisseret T, Osteaux M. Annular tears and disk herniation: prevalence and contrast enhancement on MR images in the absence of low back pain and sciatica. Radiology 1998;206: 49–55.

    PubMed  CAS  Google Scholar 

  7. Modic M, Steinberg P, Ross J, Masaryk T, Carter J. Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology 1988;166: 193–199.

    PubMed  CAS  Google Scholar 

  8. Weishaupt D, Zanetti M, Hodler J, Boos N. MR imaging of the lumbar spine: prevalence of intervertebral disk extrusion and sequestration, nerve root compression, end plate abnormalities, and osteoarthritis of the facet joints in asymptomatic volunteers. Radiology 1998;209: 661–666.

    PubMed  CAS  Google Scholar 

  9. Pathria M, Sartoris D, Resnick D. Osteoarthritis of the facet joints: accuracy of oblique radiographic assessment. Radiology 1987;164: 227–230.

    PubMed  CAS  Google Scholar 

  10. Borenstein D, O’Mara J, Boden S, et al. The value of magnetic resonance imaging of the lumbar spine to predict low-back pain in asymptomatic subjects: a seven-year follow-up study. J Bone Joint Surg Am 2001;83: 1306–1311.

    PubMed  Google Scholar 

  11. Fardon D, Milette P. Nomenclature and classification of lumbar disc pathology. Spine 2001;26: 93–113.

    Article  Google Scholar 

  12. Meyerding H. Spondylolisthesis. Surg Gynecol Obstet 1932;54: 371–377.

    Google Scholar 

  13. Atlas S, Deyo R, Keller R, et al. The maine lumbar spine study. II. One year outcomes of surgical and non-surgical managements of sciatica. Spine 1996;21: 1777–1786.

    Article  PubMed  CAS  Google Scholar 

  14. Landis J, Koch G. The measurement of observer agreement for categorical data. Biometrics 1977;33: 159–174.

    Article  PubMed  CAS  Google Scholar 

  15. Meizer R, Radda C, Stolz G, et al. MRI-controlled analysis of 104 patients with painful bone marrow edema in different joint localizations treated with the prostacyclin analogue iloprost. Wien Klin Wochenschr 2005;117: 278–286.

    Article  PubMed  Google Scholar 

  16. Zanetti M, Bruder E, Romero J, Hodler J. Bone marrow edema pattern in osteoarthritic knees: correlation between MR imaging and histologic findings. Radiology 2000;215: 835–840.

    PubMed  CAS  Google Scholar 

  17. Tien R, Olson E, Zee C. Diseases of the lumbar spine: findings on fat-suppression MR imaging. AJR Am J Roentgenol 1992;159: 95–99.

    PubMed  CAS  Google Scholar 

  18. Schmid M, Hodler J, Vienne P, Binkert C, Zanetti M. Bone marrow abnormalities of foot and ankle: STIR versus T1-weighted contrast-enhanced fat-suppressed spin-echo MR imaging. Radiology 2002;224: 463–469.

    Article  PubMed  Google Scholar 

  19. Lewin T. Osteoarthritis in lumbar synovial joints. Acta Orthop Scand 1964;73: 1–112.

    Google Scholar 

  20. Deyo R, Loeser J, Bigos S. Herniated lumbar intervertebral disk. Ann Intern Med 1990;112: 598–603.

    PubMed  CAS  Google Scholar 

  21. Junghanns H. Entwicklungsgeschichte, Anatomie und Physiologie der Wirbelsäule. Stuttgart: Thieme, 1966.

    Google Scholar 

  22. Fujiwara A, Tamai K, Yamato M, et al. The relationship between facet joint osteoarthritis and disc degeneration of the lumbar spine: an MRI study. Eur Spine J 1999;8: 396–401.

    Article  PubMed  CAS  Google Scholar 

  23. Kirkaldy-Willis W. Symposium on instability of the lumbar spine: introduction. Spine 1985;10: 254.

    Article  Google Scholar 

  24. Berlemann U, Jeszenszky D, Buhler D, Harms J. Facet joint remodeling in degenerative spondylolisthesis: an investigation of joint orientation and tropism. Eur Spine J 1998;7: 376–380.

    Article  PubMed  CAS  Google Scholar 

  25. Hermann K, Althoff C, Schneider U, et al. Spinal changes in patients with spondyloarthritis: comparison of MR imaging and radiographic appearances. Radiographics 2005;25: 559–570.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of MSK, Department of Radiology, Center of Excellence for High Field MRI, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Klaus M. Friedrich, Katja Pinker & Siegfried Trattnig

  2. Division of MSK, Department of Radiology, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Stefan Nemec, Philipp Peloschek & Michael Weber

Authors
  1. Klaus M. Friedrich
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  2. Stefan Nemec
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  3. Philipp Peloschek
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  4. Katja Pinker
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  5. Michael Weber
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  6. Siegfried Trattnig
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Correspondence to Klaus M. Friedrich.

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Friedrich, K.M., Nemec, S., Peloschek, P. et al. The prevalence of lumbar facet joint edema in patients with low back pain. Skeletal Radiol 36, 755–760 (2007). https://doi.org/10.1007/s00256-007-0293-7

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  • DOI: https://doi.org/10.1007/s00256-007-0293-7

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