Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Aug 28, 2015; 7(8): 194-197
Published online Aug 28, 2015. doi: 10.4329/wjr.v7.i8.194
Magnetic resonance imaging-based interpretation of degenerative changes in the lower lumbar segments and therapeutic consequences
Adel Maataoui, Thomas J Vogl, M Fawad Khan
Adel Maataoui, Thomas J Vogl, M Fawad Khan, Institute for Diagnostic and Interventional Radiology, Goethe University, 60590 Frankfurt am Main, Germany
Author contributions: Maataoui A, Vogl TJ and Khan MF wrote the editorial and approved the version to be published.
Conflict-of-interest statement: The corresponding authors confirm that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Adel Maataoui, MD, Institute for Diagnostic and Interventional Radiology, Goethe University, Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. adel.maataoui@gmx.de
Telephone: +49-69-63015534 Fax: +49-69-63014222
Received: January 29, 2015
Peer-review started: January 29, 2015
First decision: March 6, 2015
Revised: April 17, 2015
Accepted: May 16, 2015
Article in press: July 8, 2015
Published online: August 28, 2015

Intervertebral disc degeneration and facet joint osteoarthritis of the lumbar spine are, among others, well known as a cause of low back and lower extremity pain. Together with their secondary disorders they set a big burden on health care systems and economics worldwide. Despite modern imaging modalities, such as magnetic resonance imaging, for a large proportion of patients with low back pain (LBP) it remains difficult to provide a specific diagnosis. The fact that nearly all the lumbar structures are possible sources of LBP, may serve as a possible explanation. Furthermore, our clinical experience confirms, that imaging alone is not a sufficient approach explaining LBP. Here, the Oswestry Disability Index, as the most commonly used measure to quantify disability for LBP, may serve as an easy-to-apply questionnaire to evaluate the patient’s ability to cope with everyday life. For therapeutic purposes, among the different options, the lumbar facet joint intra-articular injection of corticosteroids in combination with an anaesthetic solution is one of the most frequently performed interventional procedures. Although widely used the clinical benefit of intra-articular steroid injections remains controversial. Therefore, prior to therapy, standardized diagnostic algorithms for an accurate assessment, classification and correlation of degenerative changes of the lumbar spine are needed.

Keywords: Low back pain, Spine, Intervertebral disc disease, Facet joint osteoarthritis, Magnetic resonance imaging, Oswestry Disability Index

Core tip: Low back pain, caused by intervertebral disc degeneration (IDD) and facet joint osteoarthritis (FJOA), is a widely spread musculoskeletal disorder in all ages worldwide. Although IDD and FJOA are common findings on lumbar magnetic resonance-imaging, the relationship between imaging findings and clinical pain-presentation as well as the benefit of different therapeutic options often remains unclear. This article briefly reviews the correlation of IDD and FJOA with clinical pain scores and discusses possible treatment options of FJOA with focus on the intra-articular injection of corticosteroids.