© 2002 The Fellowship of Postgraduate Medicine
An uncommon cause of lumbar radiculopathy
- The sagittal T2-weighted image shows low signal (suggestive of disc degeneration) at L4/5 and L5–S1 levels and a high intensity cystic lesion at L4/5 level with a low signal intensity rim due to the cyst wall.
- The axial T2-weighted image shows that the cystic lesion arising from the right L4/5 facet joint and indenting the theca posterolaterally.
- Facet joint hypertrophy/arthritis.
Facet joint cyst is the diagnosis. Facet joint cysts can be either synovial cysts or ganglia. Synovial cysts have a synovial lining and communicate with the joint whereas ganglia, in a similar site, lack a synovial lining but otherwise have similar components. Only histopathological examination can aid in differentiating between the two. Both types of the cysts arise in association with degenerative disease of spine and can cause similar symptomatology.
Surgical decompression and resection of the cyst has been the most effective and widely used treatment modality in symptomatic patients.
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Postgrad. Med. J. 2002 78: 182.
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