Presentation
Vague back pain
Patient Data
Multiple facet joints (particularly right L3/4, left L4/5 and left L5/S1) demonstrate osteoarthritic change with osteophytes and hypertrophy. Additionally, there is probably an undisplaced pars defect on the right at L5.
Vertebral height, disc height, alignment and bone marrow signal are within normal limits. The canal and neural exit foramina are capacious at all levels. The conus terminates at the T12/L1 level and is normal in appearance.
Case Discussion
It is exceedingly common for lumbar spines to demonstrate degenerative change and not all such change is symptomatic. In this instance, the facet joint degenerative change is likely contributing to the patient's symptoms.
It is worth including the prevalence of change in routine reports as a comment along with a reference.
Comment
The following findings are so common in people without low back pain that while we report their presence, they must be interpreted with caution and in the context of the clinical situation.
Among people between the age of 40 and 60 years who do not have back pain, an MRI will find that about 80% have some form of disc degeneration:
~70% have disc signal loss (desiccation)
~60% have a bulging disc
~60% have disc height loss
~30% have a disc protrusion
~30% have an annular fissure
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