Facet Arthropathy on CT and MRI: What It Means

ByA. Mendelson, MD
Please read the disclaimer

CT or MRI reports of the spine often mention facet arthropathy, facet joint arthritis, or facet degeneration.  This simply reflects common wear-and-tear of the spine’s small joints. This article explains what facet arthropathy means, how it appears on imaging, and when it may matter for symptoms.

What Are Facet Joints?

Facet joints are small paired joints located at the back of the spine. They help guide bending and twisting and provide stability. Like hip and knee joints, they are covered with smooth cartilage. Over time, the cartilage wears down and the joint surfaces change. When this occurs, it is called facet arthropathy or facet arthritis.

What Does “Facet Arthropathy” Mean on a CT or MRI Report?

When a radiology report mentions facet arthropathy, it means the radiologist sees signs of arthritis or degeneration in these joints. You might see terms like:

  • Facet arthrosis

  • Facet degeneration

  • Facet hypertrophy

  • Facet osteoarthritis

  • Bone spurring in the facets

These findings are extremely common with age, often appearing even in people who have minimal or no back or neck symptoms.

Facet Arthropathy on CT Scans

CT uses X-rays to produce detailed images of bone. It is excellent at showing the structural changes in facet joints.

On CT, facet arthropathy may appear as:

  • Bone spurs along the joint edges

  • Narrowing of the joint space

  • Enlargement or thickening of the joint

  • Hardening of the bone under the joint surface

  • Bony overgrowth that may narrow the nerve exit openings

Facet Arthropathy on MRI

MRI shows soft tissues and nerves in greater detail. It is useful for evaluating both the joints and surrounding structures.

On MRI, facet arthropathy may show as:

  • Irregular joint surfaces

  • Thickened or hardened bone under the joint

  • Fluid or inflammation inside or around the joint

  • Small fluid-filled cysts near the joint

  • Enlargement of the joint that may narrow the spinal canal or nerve openings

MRI also shows discs, nerves, and ligaments, helping determine whether facet joints are contributing to symptoms.

Lumbar, Thoracic, and Cervical Facet Arthropathy

Reports may specify where facet arthropathy is located:

  • Cervical (neck)

  • Thoracic (mid back)

  • Lumbar (lower back)

How Radiologists Grade Facet Arthropathy

Radiology reports sometimes describe facet arthropathy as mild, moderate, or severe:

  • Mild: Small bone spurs, slight narrowing

  • Moderate: Larger spurs, more joint thickening

  • Severe: Marked enlargement, major cartilage loss, significant bony overgrowth

This grading reflects appearance, not pain level. Some people with severe imaging findings feel fine, while others with mild findings may have more symptoms.

Does Facet Arthropathy Mean Permanent Pain?

Facet arthropathy describes structural wear, but symptoms can often be improved or managed.

Helpful treatments may include:

  • Physical therapy

  • Core strengthening

  • Anti-inflammatory medications

  • Posture and activity adjustments

  • Injections around the facet joints

  • Radiofrequency ablation to reduce pain signals

  • Surgery only in more advanced cases

Imaging helps guide which treatments may be useful.

Limits of CT and MRI

CT and MRI cannot determine with certainty which facet joint is causing pain. Many people have facet arthropathy on scans without symptoms, while others have pain with minimal imaging changes. Sometimes numbing injections are used to confirm whether a joint is contributing to pain.

When to Talk to Your Doctor

You should review your imaging findings with a doctor if:

  • Pain is persistent

  • Pain limits daily activities

  • You have numbness, tingling, or weakness

  • You are unsure what the report means

Your doctor can combine your symptoms, exam, and imaging to determine the relevance of the findings.

Plain-Language Summary

Facet arthropathy on CT or MRI means there is wear-and-tear arthritis in the small joints along the back of your spine. CT shows bone changes clearly, and MRI shows both bone and soft tissues. These findings are common with aging and often do not cause major symptoms. Imaging helps guide treatment, but clinical evaluation is important to determine if facet arthritis is contributing to symptoms.

References

https://my.clevelandclinic.org/health/diseases/facet-arthropathy

https://sportsmedicine.mayoclinic.org/condition/facet-arthritis/

https://capitolimagingservices.com/what-is-facet-arthropathy/

Disclaimer: The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.

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