MR imaging of lumbar facet joint synovial cysts |
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Authors: | E Apostolaki A M Davies N Evans V N Cassar-Pullicino |
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Institution: | (1) Department of Radiology, Royal Orthopaedic Hospital, Birmingham B31 2AP, UK, GB;(2) Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, Shropshire, UK, GB |
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Abstract: | The increasing application of magnetic resonance (MR) imaging of the spine has raised the awareness of lumbar facet synovial
cysts (LFSC). This well recognised, yet uncommon condition, presents with low back pain and radiculopathy due to the presence
of an extradural mass. The commonest affected level is L4/5 with a mild degenerative spondylolisthesis a frequent associated
finding. MR imaging is the technique of choice to detect and diagnose a LFSC. This pictorial essay, drawing on experience
of 43 cases seen in 40 patients, illustrates the spectrum of appearances that can be encountered and suggest differing causes
for the variable signal characteristics exhibited. Computed tomography (CT) can be of value in some cases to aid interpretation
of the MR images. In addition, CT facet arthrography by injection of air or iodinated non-ionic contrast medium may be used
to confirm the diagnosis in doubtful cases as well as noting whether the patients presenting symptoms can be provoked. A comprehensive
review of the existing literature is presented.
Received: 22 September 1998; Revised: 29 June 1999; Accepted: 30 June 1999 |
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Keywords: | : Synovial cyst – Facet joint – MR imaging |
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