Facet joint synovial cyst

Case contributed by Andrew Dixon
Diagnosis almost certain

Presentation

Right L5 radiculopathy. ? disc prolapse

Patient Data

Age: 60 years
Gender: Female

Lumbar spine MRI

mri

L3-4: Mild circumferential disc annular bulging. Mild central canal narrowing. Mild bilateral facet joint arthropathy. Mild bilateral foraminal narrowing.

L4-5: Circumferential disc annular bulging. Moderate bilateral facet joint arthropathy. Small right posteroinferiorly located facet joint synovial cyst. Mild central canal narrowing and subarticular recess narrowing. Mild to moderate right and moderate left foraminal stenosis.

L5-S1: Moderate to severe bilateral facet joint arthropathy. There is a synovial cyst associated anterior aspect of the right facet joint measuring 10 x 6 by 10 mm. This contacts the posterior aspect of the exiting right L5 nerve root and causes anterior displacement and compression of the traversing right S1 nerve root. Normal posterior disc contour. No left foraminal stenosis or central canal stenosis.

Case Discussion

Degenerative right L5-S1 facet joint synovial cyst which contacts the exiting right L5 nerve root and also compresses the traversing right S1 nerve root.

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