Imaging of posterior element axial pain generators: facet joints, pedicles, spinous processes, sacroiliac joints, and transitional segments

Radiol Clin North Am. 2012 Jul;50(4):705-30. doi: 10.1016/j.rcl.2012.04.008.

Abstract

The role of the posterior elements in generating axial back and neck pain is well established; the imaging detection of posterior element pain generators remains problematic. Morphologic imaging findings have proved to be nonspecific and are frequently present in asymptomatic patients. Edema, inflammation, and hypervascularity are more specific for sites of pain generation, but are often overlooked by imagers if physiologic imaging techniques such as fat-suppressed T2 or contrast-enhanced T1-weighted magnetic resonance imaging, radionuclide bone scanning with single-photon emission computed tomography (CT), or (18)F-fluorodeoxyglucose positron emission tomography combined with CT are not used.

Publication types

  • Review

MeSH terms

  • Bursitis / complications
  • Bursitis / diagnosis
  • Edema / complications
  • Edema / diagnosis
  • Fluorodeoxyglucose F18
  • Humans
  • Inflammation / complications
  • Inflammation / diagnosis
  • Low Back Pain / diagnosis
  • Low Back Pain / etiology*
  • Magnetic Resonance Imaging / methods
  • Multimodal Imaging / methods*
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Sacroiliac Joint*
  • Spinal Diseases / complications
  • Spinal Diseases / diagnosis*
  • Synovitis / complications
  • Synovitis / diagnosis
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Tomography, X-Ray Computed*
  • Zygapophyseal Joint*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18