Arthritis Of Lumbar Facet Joint Research Articles

MRI-based degeneration grades for lumbar facet joints do not correlate with cartilage mechanics.

Lumbar facet joint arthritis is characterized by degeneration of articular cartilage, loss of joint spacing, and increased boney spur formation. These signs of facet joint degeneration have been previously measured using destructive biochemical and mechanical analysis. Nondestructive clinical evaluation of the facet joint has also been performed using MRI scoring, which ranks the health of the facet joint using the Fujiwara scale. However, nondestructive clinical evaluation of facet joint arthritis using standard MRI scoring provides low resolution images which result in high interobserver variability. Therefore, to assess the accuracy of nondestructive MRI analysis with regard to the health of the facet joint, this study determined whether any correlations existed between lumbar facet joint articular cartilage mechanics, facet articular cartilage biochemical signatures, and Fujiwara scores. To accomplish this aim, human cadaveric lumbar spines were obtained and imaged using T1 MRI, then independently scored by three spine researchers. An osteochondral plug from each of the L2 thru L5 facet joints was obtained and loaded under unconfined compression. The experiments showed no trends between histological images and changes in the Fujiwara score. The mechanical properties of articular cartilage (thickness, Young's modulus, instantaneous modulus, and permeability) also had no correlations with the Fujiwara score. These results show that the current Fujiwara score cannot accurately describe the biomechanics or biochemical composition of facet joint articular cartilage.

A case of septic arthritis of lumbar facet joint asymptomatically led up to iliopsoas abscess

A case of septic arthritis of lumbar facet joint asymptomatically led up to iliopsoas abscess

The Prevalence of Asymptomatic Cervical and Lumbar Facet Arthropathy: A Computed Tomography Study.

Study DesignCase control study.Purpose To determine the prevalence and degree of asymptomatic cervical and lumbar facet joint arthritis. We retrospectively reviewed 500 computed tomography (CT) scans of cervical facet joints obtained from 50 subjects. Moreover, 500 lumbar facet joints obtained from an additional 50 subjects were reviewed.Overview of LiteratureNumerous reports in the literature indicate that joint arthritis is a major source of axial neck and low back pain. However, the diagnostic value of this condition, based on degenerative changes seen on radiological studies, remains controversial because significant imaging findings may not correlate with corresponding symptoms. The CT scan is a sensitive method for facet joint evaluation and may reveal degenerative abnormalities. Previous studies have described the prevalence of facet arthropathy in symptomatic patients, according to radiological findings; however, no study to date has assessed its prevalence in asymptomatic patients.MethodsWe retrospectively reviewed the neck and abdominal CT scans of patients had been examined for non-spinal pathologies (i.e., thyroid disease, rule out cancer, ascites). Electronic medical records were reviewed to exclude patients with histories of either neck or back pain. Arthritis severity was graded using a previously published four-point CT scale.ResultsThe prevalence of asymptomatic cervical facet arthritis (grade 1–3) was 33% (grade 1, 19%; grade 2, 11%; and grade 3, 3%). Among asymptomatic patients, 37% had scalable lumbar facet join arthritis (grade 1, 24%; grade 2, 9%; and grade 3, 4%). There was a statistically significant difference (chi-square test, p<0.0001) in the number of older individuals with arthritic degeneration at the cervical and lumbar levels compared with that of younger individuals. The C6–C7 and L5–S1 levels were the most likely to show arthritic changes.ConclusionsArthritic changes to the cervical and lumbar facet joints are prevalent among patients, and in some cases are asymptomatic. These findings were more common in older patients and at lower spinal levels.

A Rare Case of Septic Arthritis of Lumbar Facet Joint with Epidural Abscess, and Bacterial Meningitis Caused by Methicillin-Sensitive Staphylococcus aureus

AbstractSeptic arthritis of the facet joint is an extremely rare condition, even more in young immunocompetent patients. There have been approximately only 40 cases of this entity reported worldwide. Here, the authors present a 16-year-old male patient with lower back pain, fever, and cephalea. Blood cultures and cerebrospinal fluid analysis confirmed methicillin-sensitive Staphylococcus aureus infection, and magnetic resonance imaging showed septic arthritis of the lumbar left facet joint L3 and epidural abscess. Intravenous oxacillin was administered, and the patient improved. No other treatment was required.

Septic arthritis of lumbar facet joint; a case report

Septic arthritis of lumbar facet joint; a case report

Pyogenic lumbar facet joint arthritis in hemodialysis patient with obesity—A case report

Pyogenic lumbar facet joint arthritis in hemodialysis patient with obesity—A case report

The Prevalence and Degree of Asymptomatic Cervical and Lumbar Facet Joint Arthritis: Retrospective Study

PM&RVolume 7, Issue 9S p. S91-S91 Best Pain and Spine Medicine Research Podium Presentation The Prevalence and Degree of Asymptomatic Cervical and Lumbar Facet Joint Arthritis: Retrospective Study Mohammed Emam MD, Mohammed Emam MD Montefiore Medical Center, Bronx, NY, United StatesSearch for more papers by this authorFerdinand Chan MD, Ferdinand Chan MD Montefiore Medical Center, Bronx, NY, United StatesSearch for more papers by this authorSoo Yeon Kim MD, Soo Yeon Kim MD Montefiore Medical Center, Bronx, NY, United StatesSearch for more papers by this authorAlok Sharan MD, Alok Sharan MD Montefiore Medical Center, Bronx, NY, United StatesSearch for more papers by this author Mohammed Emam MD, Mohammed Emam MD Montefiore Medical Center, Bronx, NY, United StatesSearch for more papers by this authorFerdinand Chan MD, Ferdinand Chan MD Montefiore Medical Center, Bronx, NY, United StatesSearch for more papers by this authorSoo Yeon Kim MD, Soo Yeon Kim MD Montefiore Medical Center, Bronx, NY, United StatesSearch for more papers by this authorAlok Sharan MD, Alok Sharan MD Montefiore Medical Center, Bronx, NY, United StatesSearch for more papers by this author First published: 08 September 2015 https://doi.org/10.1016/j.pmrj.2015.06.041Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume7, Issue9SSeptember 2015Pages S91-S91 RelatedInformation

Lumbar Facet Joint Arthritis Is Associated with More Coronal Orientation of the Facet Joints at the Upper Lumbar Spine

We retrospectively analyzed CT scans of 620 individuals, who presented to our traumatology department between 2008 and 2010. Facet joint (FJ) arthritis was present in 308 (49.7%) individuals with a mean grade of 1. It was seen in 27% of individuals ≤40 years and in 75% of individuals ≥41 years (P < 0.0001) as well as in 52% of females and 49% of males (P = 0.61). Mean FJ orientation was 30.4° at L2/3, 38.7° at L3/4, 47° at L4/5, and 47.3° at L5/S1. FJ arthritis was significantly associated with more coronal (increased degree) FJ orientation at L2/3 (P = 0.03) with a cutoff point at ≥32°. FJs were more coronally oriented (48.8°) in individuals ≤40 years and more sagittally oriented (45.6°) in individuals ≥41 years at L5/S1 (P = 0.01). Mean FJ asymmetry was 4.89° at L2/3, 6.01° at L3/4, 6.67° at L4/5, and 7.27° at L5/S1, without a significant difference for FJ arthritis. FJ arthritis is common, increases with age, and affects both genders equally. More coronally oriented FJs (≥32°) in the upper lumbar spine may be an individual risk factor for development of FJ arthritis.

Septic Arthritis of Lumbar Facet Joint with Co-Existing Spondylolisthesis – A Case Report

We report a rare case of septic arthritis of the lumbar facet joint (SALFJ) with co-existing spondylolisthesis of the L5 on S1 vertebra and discuss possible differential diagnoses, diagnostic difficulties and management of this condition.

Septic Arthritis of a Posterior Lumbar Facet Joint in an Infant

: Case report. : To describe a case of septic arthritis of the facet joint in an infant. : To our knowledge, no more than 50 cases of septic arthritis of a facet joint are reported in literature, including only 4 cases in children and none in infants. : A girl of age 18 months presented with a fever pattern of 4 days evolution, right lumbar paravertebral tumefaction with local inflammatory signs and limping related to pain with weight-bearing on the right lower extremity. The mother reported a pharyngeal infection 2 weeks earlier.Conventional radiology showed no alterations. MR and scintigraphy with radioactivity-marked leukocytes showed affectation only of the posterior facet joint of right L4-L5, without associated collections. Blood and urine cultures were negative. The diagnosis was established as right L4-L5 septic arthritis of a lumbar facet joint, probably of hematogenous origin. : The fever pattern and the limp disappeared in 24 hours with wide-spectrum empirical intravenous antibiotherapy. Although no microorganism was isolated, the good response to the empirical treatment and the background of pharyngeal infection point to a hematogenous dissemination by Staphylococcus aureus or Streptococcus spp. : Septic arthritis of a facet joint does not differ clinically from other spinal infections and its incidence is possibly underestimated in favor of other more common entities. Only imaging techniques can differentiate the affected structures and establish the exact diagnosis.MR allows the detection in initial stages, delimits the affectation and extension through the soft tissues, and rules out other more common entities such as discitis. Scintigraphy and SPECT can detect other active foci and be useful in the follow-up.The result achieved with antibiotic treatment in early stages is usually satisfactory. Surgical debridement is only necessary when associated purulent collections appear. From the pediatric point of view, spinal infections should also be taken into consideration within the differential diagnostic of limp in children.

A Case of the Lumbar Spine Involvement and Sacroiliitis in a Patient with Gout

Although gout often initially affects the peripheral joints, gout may also involve the axial joints. The radiologic changes of axial gout are more common than are clinically recognized. According to a recent report, when the spine CT images of peripheral gout were reviewed for features of axial gout, there was about a 14% frequency of suspected axial gout. The vertebral level and the finding with the most common spinal gouty changes were L4 and lumbar facet joint erosions. We describe here the case of a 36-year-old gout patient with low back and right buttock pain and his lesions were unexpectedly diagnostic of lumbar facet joint arthritis and right sacroiliitis.

Viscosupplementation in Lumbar Facet Joint Arthropathy

Degeneration of the spine is a prevalent problem that generally advances with age, although its occurrence is not restricted to the elderly. Chronic low back pain is a common problem with several treatments, but rigorous evaluation of many interventions is still lacking. One of the most common methods of treating lumbar facet arthropathy is intra-articular injection of local anesthetic and steroid. However, in large joints, such as the knee, viscosupplementation has been shown to compare favorably to steroid in terms of symptom relief and duration of benefit. It is suggested that viscosupplementation may supersede steroid in treatment of symptomatic knee osteoarthritis. Hyaluronic acid (HA) therapy is still in its infancy in joints outside the knee, although some preliminary results are promising. This was a pilot study to test the potential effectiveness of HA injection therapy in the treatment of lumbar facet joint arthritis. Thirteen patients with symptomatic lumbar facet joint arthritis who met the inclusion criteria were prospectively recruited. Pretreatment evaluation of patients was by questionnaire, including the Visual Analog Score and Oswestry Disability Questionnaire. A single injection of HA into affected facet joints was then performed, with correct placement confirmed on fluoroscopy. The patients were similarly evaluated 6 weeks after treatment. Eighteen facets in 13 patients were injected with HA. At 6-week follow up, there was no significant improvement in pain when measured on the Visual Analog Score. There was also no significant improvement in the Oswestry Disability Questionnaire. Preliminary results from this pilot study do not demonstrate any benefit of viscosupplementation in the management of symptomatic lumbar facet arthropathy.

Septic Arthritis of Lumbar Facet Joints Without Predisposing Infection

Septic arthritis of a lumbar facet joint is a rare clinical entity and most articles have reported a single case. There have been few studies that have evaluated the clinical and imaging features of septic arthritis of lumbar facet joints. The clinical data of 5 patients diagnosed with septic arthritis of lumbar facet joints were retrospectively studied. The average age of 5 patients was 73.6 years. All patients had elevated temperature at admission (37.7 degrees C). Leukocyte count was tested in all 5 patients and was elevated in only 2 patients. Erythrocyte sedimentation rate and C-reactive protein were examined and were elevated in all 5 cases. Magnetic resonance imaging was accurate in identifying the septic joint and associated abscess formation. All patients were treated with bed rest and received intravenous antibiotics for an average of 33.3 days. Four of 5 patients had positive outcomes with full recoveries and no evidence of recurrent infections. One patient exhibited evidence of recurrent infection and required open facet arthrotomy and paraspinal muscle debridement after intravenous administration of antibiotics. Septic arthritis of the lumbar facet joint is a rare cause of low back pain. It is important to ascertain the diagnosis at the earliest possible stage and to start intravenous antibiotics therapy as soon as possible. Magnetic resonance imaging is quite a sensitive modality for identifying infection of the lumbar facet joint. Familiarity with its clinical symptoms and radiographic features is necessary to avoid misdiagnosis of this condition.

Group B Streptococcal Facet Joint Arthritis

Case report. To report a previously undescribed complication of group B streptococcal infective endocarditis, which was lumbar facet joint arthritis. Lumbar facet joint arthritis is a rare clinical condition, and the casual pathogen is generally Staphylococcus aureus. Streptococcus agalactiae usually causes peripartum infections affecting the mother and newborn. It rarely causes infective endocarditis, and facet joint arthritis has never been reported before. A case of group B streptococcal infective endocarditis and lumbar facet joint arthritis is described. The clinical course, treatment, and complications of facet joint arthritis and infective endocarditis are discussed. A nonimmunocompromised patient presenting with fever and back pain was diagnosed to have S. agalactiae bacteremia. Subsequent imaging with echocardiography revealed mitral valve infective endocarditis and magnetic resonance imaging of lumbar spine showed left L5-S1 facet joint arthritis. Emergent intravenous antibiotic treatment and mitral valve replacement resulted in complete resolution. Facet joint septic arthritis should be considered in the differential diagnosis of patients presenting with fever and back pain. S. agalactiae should also be considered among the causal pathogens, and, if present, emergent antibiotic treatment, follow-up for complications, and a thorough search for the source of the hematogenous spread, which can be a life-threatening infection, are essential.

Septic arthritis of lumbar facet joints; A report of two cases

Septic arthritis of lumbar facet joints; A report of two cases