Lumbar spinal synovial cyst

Case contributed by Dr Dalia Ibrahim

Presentation

Back and right leg pain.

Patient Data

Age: 60 years
Gender: Female
MRI
  • Bilateral hypertrophic L4/5 facet arthropathy associated with bilateral facet synovial cysts (larger on the right side)
    • The right facet synovial cyst shows cranial inclination and is seen encroaching upon the right L4 neural exit foramen and compressing the corresponding nerve root.
    • The left facet synovial cyst encroaches upon the left L5 nerve root.  
  • L4/5 diffuse posterior disc bulge.
  • L5/S1 small central posterior disc protrusion.
  • D12/L1 central posterior disc protrusion.
  • Mild ventral wedging of L1 vertebra.
Annotated image

Bilateral hypertrophic L4/5 facet arthropathy associated with bilateral facet synovial cysts (larger in the right side)

  • The right facet synovial cyst shows cranial inclination and is seen encroaching upon the right L4 neural exit foramen and compressing the corresponding nerve root.
  • The left facet synovial cyst encroaches upon the left L5 nerve root.  

Case Discussion

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

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Case information

rID: 52446
Case created: 7th Apr 2017
Last edited: 12th Apr 2017
Inclusion in quiz mode: Included

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