Types of synovial fold in the cervical facet joint

Inami, Satoshi; Kaneoka, Koji; Hayashi, Koichiro; Ochiai, Naoyuki

doi:10.1007/s007760070026

Cited by 44 publications

(50 citation statements)

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“…The degree of an individual's sagittal and coronal head tilt [48] might also influence the size of the ventral and dorsal synovial folds and right and left synovial folds, respectively. Based upon observations from cadaver studies, it is suggested that the morphology of the synovial folds changes in association with increasing age and/or articular degeneration [15,25,33,51,62]. In agreement with Friedrich et al [17] and Webb et al [60], neither of these age-related observations was verified by the results of the present study.…”

Section: Discussionsupporting

confidence: 90%

The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study

2010

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The purpose of this study was to investigate the effect of age, anthropometrics and cervical range of motion upon synovial fold volume. Ten healthy female subjects aged 20-40 years were included in the study. Age, height, body mass, dimensions of the head and neck and cervical range of motion of each subject were measured. Magnetic resonance (MR) images of the cervical spine were acquired; the volume of the ventral and dorsal synovial folds of the right and the left lateral atlanto-axial joints was measured using seed growing and thresholding methods. Using Spearman's correlation coefficient, it was determined that there was no correlation between synovial fold volume and age. Synovial fold volume was positively correlated with subject height and neck length but negatively correlated with body mass, body mass index and the circumference of the head and neck. The relationship between synovial fold volume and range of cervical motion varied with the plane of movement. The ability to image the synovial folds of the lateral atlanto-axial joints using MR imaging to determine their normal morphology provides the basis for investigating synovial fold pathology in patients with neck pain and headache.

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Section: Discussionsupporting

confidence: 90%

The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study

2010

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“…A recent review article concluded that more than 50% of patients presenting to a pain clinic with neck pain may suffer from facet-related pain. 69 Several studies report the presence of synovial folds, 32,68,76 meniscoids, 19 and fat pads 65 within facet joints that may become entrapped during aberrant motions of the cervical spine and lead to the onset of neck pain. It seems plausible that if such entrapment did occur, motions that would require the affected joints to close down against the entrapped tissues would provoke symptoms.…”

mentioning

confidence: 99%

Development of a Clinical Prediction Rule to Identify Patients With Neck Pain Likely to Benefit From Thrust Joint Manipulation to the Cervical Spine

Puentedura¹,

Cleland²,

Landers³

et al. 2012

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Prospective cohort/predictive validity study. Objective To determine the predictive validity of selected clinical examination items and to develop a clinical prediction rule to determine which patients with neck pain may benefit from cervical thrust joint manipulation (TJM) and exercise. Background TJM to the cervical spine has been shown to be effective in patients presenting with a primary report of neck pain. It would be useful for clinicians to have a decision-making tool, such as a clinical prediction rule, that could accurately identify which subgroup of patients would respond positively to cervical TJM. Methods Consecutive patients who presented to physical therapy with a primary complaint of neck pain completed a series of self-report measures, then received a detailed standardized history and physical examination. After the clinical examination, all patients received a standardized treatment regimen consisting of cervical TJM and range-of-motion exercise. Depending on response to treatment, patients were treated for 1 or 2 sessions over approximately 1 week. At the end of their participation in the study, patients were classified as having experienced a successful outcome based on a score of +5 (“quite a bit better”) or higher on the global rating of change scale. Sensitivity, specificity, and positive and negative likelihood ratios were calculated for all potential predictor variables. Univariate techniques and stepwise logistic regression were used to determine the most parsimonious set of variables for prediction of treatment success. Variables retained in the regression model were used to develop a multivariate clinical prediction rule. Results Eighty-two patients were included in data analysis, of whom 32 (39%) achieved a successful outcome. A clinical prediction rule with 4 attributes (symptom duration less than 38 days, positive expectation that manipulation will help, side-to-side difference in cervical rotation range of motion of 10° or greater, and pain with posteroanterior spring testing of the middle cervical spine) was identified. If 3 or more of the 4 attributes (positive likelihood ratio of 13.5) were present, the probability of experiencing a successful outcome improved from 39% to 90%. Conclusion The clinical prediction rule may improve decision making by providing the ability to a priori identify patients with neck pain who are likely to benefit from cervical TJM and range-of-motion exercise. However, this is only the first step in the process of developing and testing a clinical prediction rule, as future studies are necessary to validate the results and should include long-term follow-up and a comparison group. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther 2012;42(7):577–592, Epub 14 May 2012. doi:10.2519/jospt.2012.4243

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“…2,5) A study of synovial folds in cervical facet joints based on dissecting from C2 to C7 in 20 cervical spines showed that such folds were present in 88 of 115 facet joints (76%). 10) Fibrous changes in fatty tissue in the joint 5) and the generation of connective tissue triggered by mechanical stress between the articular surfaces 12) are also possibilities. Based on the location and the histological diagnosis of proliferated fibrous connective tissue, we concluded that the soft tissue lesions occupying the joint space in our patient were synovial folds.…”

Section: Discussionmentioning

confidence: 99%

“…1,3,6,17) However, few studies have considered the cervical facet joint. 10,16,23) The mechanism underlying the formation of a hypertrophic synovial mass remains to be elucidated. The present and previous cases of hypertrophic synovial mass arose from a facet manifesting degenerative changes, and the histological diagnoses were proliferated fibrous connective tissue that appeared to be formed by mechanical stress between the articular surfaces.…”

Section: Discussionmentioning

confidence: 99%

Hypertrophic Synovial Mass Resulting in C8 Radiculopathy -Case Report-

Sasamori

Isu

Morimoto

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 58-year-old man presented with a hypertrophic synovial mass manifesting as left C8 radiculopathy. Computed tomography revealed hypertrophic changes in the left C7-T1 facet joint and widening of the interarticular space. Magnetic resonance imaging showed left C7-T1 foraminal stenosis attributable to a periarticular mass enhanced with gadolinium. Decompression surgery of the left C8 nerve root was performed. During left C7-T1 facetectomy we detected inflamed soft tissue occupying the interarticular space with extension toward the intervertebral foramen. The mass markedly compressed the left C8 nerve root and was gross totally removed. The histological diagnosis was proliferated fibrous connective tissue compatible with hypertrophic synovial tissue. Postoperatively, his neurological condition improved remarkably. The surgical and pathological findings in our patient indicate that this clinical condition is important in the differential diagnosis in adult patients presenting with cervical radiculopathy.

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Types of synovial fold in the cervical facet joint

Cited by 44 publications

References 10 publications

The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study

The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study

Development of a Clinical Prediction Rule to Identify Patients With Neck Pain Likely to Benefit From Thrust Joint Manipulation to the Cervical Spine

Hypertrophic Synovial Mass Resulting in C8 Radiculopathy -Case Report-

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