Presence and extent of severe facet joint osteoarthritis are associated with back pain in older adults

Abstract

Objective To determine whether the presence and extent of severe lumbar facet joint osteoarthritis (OA) is associated with back pain in older adults, accounting for disc height narrowing and other covariates. Design 252 older adults from the Framingham Offspring Cohort (mean age 67 years) were studied. Participants received standardized CT assessments of lumbar facet joint OA and disc height narrowing at the L2-S1 interspaces using 4-grade semi-quantitative scales. Severe facet joint OA was defined according to the presence and/or degree of joint space narrowing, osteophytosis, articular process hypertrophy, articular erosions, subchondral cysts, and intraarticular vacuum phenomenon. Severe disc height narrowing was defined as marked narrowing with endplates almost in contact. Back pain was defined as participant report of pain on most days or all days in the past 12 months. We used multivariable logistic regression to examine associations between severe facet joint OA and back pain, adjusting for key covariates including disc height narrowing, sociodemographics, anthropometrics, and health factors. Results Severe facet joint OA was more common in participants with back pain than those without (63.2% vs. 46.7%;p=0.03). In multivariable analyses, presence of any severe facet joint OA remained significantly associated with back pain (odds ratio[OR]2.15 (95% confidence interval [CI]1.13-4.08). Each additional joint with severe OA conferred greater odds of back pain (OR per joint 1.20 (95% CI;1.02-1.41). Conclusions The presence and extent of severe facet joint OA on CT imaging is associated with back pain in community-based older adults, independent of sociodemographics, health factors, and disc height narrowing.

In vivo feasibility of real-time MR–US fusion imaging lumbar facet joint injections

“…[6]. Several radiological classifications of facet joints degeneration have been proposed; among these the most reliable is the Grogan classification, which is based on CT findings and ranges from uniform thick cartilage and thin cortical bone to complete absence of cartilage with marginal osteophytes and dense cortical bone greater than half the facet joint [20].…”

“…Diagnostic imaging is proved to be an accurate and reliable tool for the assessment of FJ degenerative changes and its correlation with clinical symptomatology and pathological grading. [5,6]. A correct diagnosis can be made with computed tomography (CT) or magnetic resonance (MR) demonstrating inflammation, swelling, or degenerative changes of FJ.…”

Radiological Pain Predictors in Knee Osteoarthritis, a Four Feature Selection Comparison: Data from the OAI

“…Since men are generally taller, all image features from the quantitative datasets went through a height and gender adjustment using a linear regression [33]:…”

Low Back Pain due to Lumbar Facet Joint Arthropathy and its Management

“…As any typical synovial joint, facet joints have two articular surfaces formed by inferior articular process (IAP) of the upper vertebra and the superior articular process (SAP) of the lower vertebra [2]. Facet joints are potential source of pain in low back pain (LBP) and its prevalence increases with age [3,4].…”

“…Disk degeneration leads to abnormal weight transfer and motion in the spine and results in facet joint arthritis [6]. It has been reported that as many as 89% -95% individuals of 65 and older have varying degrees of Facet Joint Arthritis (FJAO) and the L4-5 and L5-S1 are the most commonly affected joints [1,3,4,6].…”