The patient’s medical history (anamnesis) in the case of a facet syndrome and the symptoms described are indicative. Also the physical examination of the facet syndrome with exclusion of root irritation symptoms, pressure pain over the vertebral joints (spring pain, medically called springing test), pain intensification in case of reclination (back bending) and movement restriction of the lumbar spine provides important information for the diagnosis of the clinical picture. Imaging techniques help to diagnose the disease facet syndrome and its extent.
X-ray image
In principle, X-ray imaging of the spine can be described as basic imaging diagnostics. The X-rays provide the treating physician with an insight into the spinal column posture. In addition, bony changes (calcium salt reduction-osteoporosis, spinal curvature, a vertebral fracture, vertebral joint arthrosis-spondylarthrosis, vertebral body attachments) and intervertebral disc depressions can be detected. However, an x-ray does not show the extent to which vertebral joint arthrosis leads to the compression of nerve structures. This requires cross-sectional imaging techniques such as CT (computed tomography) and MRI (magnetic resonance imaging), which can show the width of the spinal canal and the spinal nerves (spinal cord nerves) in different views due to their sectional design.
CTMRT of the back (especially cervical and lumbar)
The sectional image diagnostics (CT and MRI of the back, either with or without contrast medium) allows the pain to be assigned to a specific nerve or spinal section. Diagnosis using CT (computed tomography) examination can be used in particular to answer more detailed questions regarding the bony structure (e.g. spondylarthrosis, spinal canal stenosis, vertebral body fracture). Even more valuable in spinal diagnostics, however, is the diagnosis by means of MRI of the HWSMRT of the lumbar spine (magnetic resonance imaging), which, in addition to the bony structures, is much better than CT, also shows the soft tissue structures (intervertebral discs, nerve roots, ligaments).
All of the above-mentioned diseases can be detected by MRI and assigned to a specific spinal column section. None of the diagnostic procedures mentioned, however, is evidence of a facet syndrome. Even if there is clear evidence of vertebral joint arthrosis, this image diagnosis is not necessarily the cause of the complaint. For further diagnostics, sample injections into the vertebral joints are therefore suitable.
