The clinical ability of contrast-enhanced magnetic resonance imaging to predict treatment outcomes for lumbar facet joint pain

Ann Palliat Med. 2021 Feb;10(2):1431-1437. doi: 10.21037/apm-20-313. Epub 2020 Oct 26.

Abstract

Background: Several radiologic imaging techniques have been used to predict the effects of treatment on lumbar facet joint (LFJ) pain. However, there are no reports on the use of contrast-enhanced magnetic resonance imaging (MRI) in the management of LFJ pain. In the current study, we aimed to evaluate the clinical ability of contrast-enhanced MRI to predict treatment outcomes for LFJ pain.

Methods: A total of 26 patients with LFJ pain were recruited and intraarticular (IA) corticosteroid injections were administered to each patient. We assessed the treatment outcomes using a numerical rating scale (NRS), and two radiologists independently investigated LFJ enhancement and osteoarthritis grading. No serious complications or adverse events were reported.

Results: IA corticosteroid injections were administered to 26 patients (12 women and 14 men; mean age: 65.19±11.05 years) with LFJ pain. Among the 26 patients, 16 patients were included in the facet joints with enhancement group, and the remaining 10 patients were included in the facet joints with non-enhancement group, based on contrast-enhanced MRI scans. In both the enhancement and non-enhancement groups, NRS scores significantly decreased at 1, 2, and 3 months after treatment (P<0.05). However, we saw no significant difference between the groups from pretreatment to three months after treatment (P>0.05).

Conclusions: The routine use of contrast-enhanced MRI is not recommended in patients with LFJ pain.

Keywords: Magnetic resonance imaging (MRI); image enhancement; injection; intraarticular injection (IA injection); low back pain; treatment; zygapophyseal joint.

MeSH terms

  • Aged
  • Female
  • Humans
  • Injections, Intra-Articular
  • Low Back Pain*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Treatment Outcome
  • Zygapophyseal Joint* / diagnostic imaging