Magnetic Resonance Imaging Can Detect Symptomatic Patients with Facet Joint Pain. A Retrospective Analysis

Background: Low back pain has recently been reported as the leading cause for disability worldwide. The diagnostic value of imaging has been estimated low. Led by own positive experience, however, we hypothesized that MRI can detect signs of facet joint pain. Methods: 15 patients and 15 controls were retrospectively assessed by two readers. They compared deidentifi ed T2 weighted lumbar spine MRI scans. Facet joint size, shape, angle, joint space signal and degeneration were rated. Pain aetiology was proven with the diagnostic gold standard of medial branch blocks. Results: Facet joint angles and joint diameters were signifi cantly larger in symptomatic patients, who also showed signifi cantly higher grades of degeneration but no difference in joint space distances or shape or signal intensity. The readers were able to correctly identify symptomatic patients with good interrater reliability (kappa 0.5, sensitivity and specifi city 0.87-0.93), positive (LR+= 6.7-7.2) and negative likelihood ratios (LR-=0.15). Conclusions: Contrary to recent publications, we could demonstrate differences between asymptomatic and symptomatic subjects showing the latter to have larger joints and more signs of degeneration. One can conclude from the strong LR+ and LRvalues that MRI is a useful investigation to rule in or rule out facet pain. Research Article Magnetic Resonance Imaging Can Detect Symptomatic Patients with Facet Joint Pain. A Retrospective Analysis Wolfgang Freund1,2*, Frank Weber3, Reinhard Meier1 and Stephan Klessinger4,5 1Diagnostic and Interventional Radiology, University Hospitals Ulm, Germany 2Neurology Outpatient Clinic, Biberach, Germany 3German Air Force Center of Aerospace Medicine, Fuerstenfeldbruck, Germany 4Neurosurgery, University Hospitals Ulm, Germany 5Neurosurgery, Nova Clinic, Biberach, Germany *Address for Correspondence: Dr. Wolfgang Freund, Professor, Diagnostic and Interventional Radiology, University Hospitals Ulm, AlbertEinstein-Allee 2389081 Ulm, Germany, Email: [email protected] Submitted: 04 March 2016 Approved: 24 March 2017 Published: 27 March 2017 Copyright: 2017 Freund W, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.