What are the facet joints and how does pathology in them manifest?

What are the facet joints and how does pathology in them manifest?

The facet joints are the paired posterior articulations of the vertebrae and are typical synovial joints. Synovitis and articular degeneration causes local tenderness over the involved joint with referred pain to the buttock and posterolateral leg.

Pain from facet disease, sacroiliitis, and lumbar sacral radiculopathy can often mimic each other. The diagnosis of facet joint disease can only be made by performing a com-plete physical examination and correlating the findings with radiographic information.

Treatment involves injecting local anesthetic and steroids directly into the facet joint. For longer-lasting effect, neurolysis of the medial branch nerve that innervates the joint with radiofrequency lesioning can be done.