Facet joint synovial cyst

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis almost certain


Left sciatica, left leg pain and numbness.

Patient Data

Age: 70 years
Gender: Female

Bilateral hypertrophic osteoarthropathy of L5/S1 facet joint. An ovoid well defined intraspinal lesion is seen in relation to the anteromedial aspect of the left L5/S1 facet joint. It appears low signal on T1 and relatively high signal on T2 surrounded by low outline.

Associated hypertrophied ligamenta flava augment thecal compromise at that level.  Lower lumbar apophyseal joints hypertrophic arthropathies from L3/4 down.

Multiple lumbar disc bulges are seen more at L4/5 level. They indent the opposing aspect of the thecal sac with encroachment upon preforaminal portion of the passing nerve roots at L4/5 levels.

Case Discussion

Spinal facet synovial cysts that are more common in elderly females (>50 years old). They are classically associated with osteoarthritis of the apophyseal facet joints. 

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