Article

OBJECTIVE: To determine the frequency of facet joint (FJ) bone marrow lesions,
high FJ periarticular signal intensity, and FJ effusions in a convenience sample
of patients with axial low back pain (LBP). DESIGN: A cross-sectional pilot study
with retrospective data collection. SETTING: Outpatient spine clinics. PATIENTS:
Sixty-four adults with axial LBP scheduled to receive an FJ intra-articular
corticosteroid injection. METHODS: Clinical data were abstracted from the medical
record by 1 physician, who was blinded to results of the magnetic resonance
imaging evaluations. A musculoskeletal radiologist blinded to clinical
information performed standardized assessments of the L1-S1 spinal levels for FJ
bone marrow lesions, effusions, and high periarticular signal intensity on lumbar
magnetic resonance imaging, including short tau inversion recovery sequences. We
calculated the frequency of these FJ features and used generalized estimating
equations to examine side-specific associations between the location of FJ
features and the side on which LBP was experienced. RESULTS: The sample included
64 participants with a mean (standard deviation) age of 59.9 +/- 14.5 years. FJ
bone marrow lesions were present in 64.1%, effusions in 70.3%, and high
periarticular signal intensity in 65.6% of participants. All the features were
most common at the L4-L5 level. These FJ features showed significant associations
with the side on which LBP was experienced or statistical trends toward an
association, with or without adjustment for age, gender, and body mass index. The
strongest side-specific associations were seen for the number of bone marrow
lesions (odds ratio [OR] 1.60 [95% confidence interval {CI},1.05-2.43]), any FJ
effusion (OR 2.23 [95% CI, 1.02-4.85]), and the number of joints with high
periarticular signal intensity (OR 1.75 [95% CI, 1.16-2.63]). CONCLUSIONS: FJ
bone marrow lesions, effusions, and high periarticular signal intensity were
common in this sample of patients with axial LBP and substantially more frequent
than in prior reports from unselected samples of patients with or without
radicular pain. These FJ features demonstrate side-specific associations with
LBP. Further study of associations between these FJ features and LBP are
warranted.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS