[The role of computed tomography and magnetic resonance in assessing degenerative arthropathy of the lumbar articular facets].

Degenerative arthropathy of the lumbar facet joints remains a debated issue relative to both its etiopathogenesis and its clinical significance. The authors studied 9 autoptic specimens by means of CT and MRI: the diagnostic value of the two methods was assessed taking the histopathologic findings of the relative specimens as the gold standard. The following signs of degenerative arthropathy were investigated in each specimen: cartilaginous wears, hypertrophy of the articular processes, osteophytosis, subchondral sclerosis and geodes and capsular and ligamentous calcifications. CT clearly demonstrated the characteristic signs of arthropathy, although failing to assess the cartilaginous wears in the early degeneration phases. Cartilaginous surface tears were directly depicted by MRI in the specimens showing medium and advanced degeneration. In our opinion, CT represents the examination of choice in the diagnosis of degenerative arthropathy of the lumbar apophyseal joints. Nevertheless, human trials are needed to assess MR capabilities in better detailing subchondral bone structure and in depicting the joint capsule and the synovial membrane and fluid as a major MR potential to diagnose back pain syndromes arising from the posterior arch.