Case Of the Week (COW) 14 April 2013
Answer:
SUPERIOR ARTICULAR FACET SYNDROME
Findings
There is moderate left L4-L5 facet hypertrophy and degeneration.
The L5 superior articular process and associated hypertrophied ligaments are encroaching the left neuroforamen and impinging the left exiting L4 nerve root, which appears hyperintense in STIR sequence.
The above features reflect left Lateral Spinal Stenosis and Superior articular facet Syndrome with left L4 nerve root /Dorsal root ganglion intraneural edema
Discussion
The Superior Articular Facet (SAF) Syndrome is an important cause of Back pain underdiagnosed and frequently missed radiologically.
The lateral spinal stenosis is often missed diagnostically and though considered to a rare entity , it is not the case.
The SAF syndrome is a type of lateral spinal stenosis frequently seen in patients with underlying spine disoders and characterized by degeneration of facet joints causing the superior articular facet of the lower vertebra to project into the foramen and compress the exiting spinal nerve root.
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai
Answer:
SUPERIOR ARTICULAR FACET SYNDROME
Findings
There is moderate left L4-L5 facet hypertrophy and degeneration.
The L5 superior articular process and associated hypertrophied ligaments are encroaching the left neuroforamen and impinging the left exiting L4 nerve root, which appears hyperintense in STIR sequence.
The above features reflect left Lateral Spinal Stenosis and Superior articular facet Syndrome with left L4 nerve root /Dorsal root ganglion intraneural edema
Discussion
The Superior Articular Facet (SAF) Syndrome is an important cause of Back pain underdiagnosed and frequently missed radiologically.
The lateral spinal stenosis is often missed diagnostically and though considered to a rare entity , it is not the case.
The SAF syndrome is a type of lateral spinal stenosis frequently seen in patients with underlying spine disoders and characterized by degeneration of facet joints causing the superior articular facet of the lower vertebra to project into the foramen and compress the exiting spinal nerve root.
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai