Radiologic recognition of symptomatic spinal synovial cysts.

Synovial cysts of diarthrodial joints have long been recognized [1]. Clinically, they have most often been found in association with one of the arthritides [2,3]. Though synovial cysts can involve the facet joints of the spine, this fact was little appreciated until very recently [4, 5]. Radiographically, these lesions were extremely difficult to diagnose and were rarely recognized preoperatively. With the advent of computed tomography (CT), spinal synovial cysts could be clearly imaged. In a recent case report , Hemminghytt et al. [6] emphasized that these cysts usually present with pain but without additional sensory or motor findings. Therefore, surgery would not be indicated in most cases, presumably because these cysts incidentally accompany the facet syndrome of lumbar facet arthropathy. The lumbar synovial cyst described here, which was documented by contrast opacification at facet arthrography and by subsequent surgery, compressed the adjacent nerve root and ultimately required excision to relieve the patient's radiculopathy.