INTEREXAMINER RELIABILITY OF T2-WEIGHTED MAGNETIC RESONANCE IMAGING FOR LUMBAR BRIGHT FACET SIGN

Objective: The aims of this study were to characterize the bright facet response within the lumbar spine, to identify a constellation of findings associated with the response, and to quantify the interexaminer agreement on the previous objectives. Methods: A retrospective study of lumbar magnetic resonance images obtained on 105 (N = 105) adult subjects (62 men and 43 women; age range, 18-84 years; mean age, 46.51 +/- 16.01 years) were reviewed by 2 musculoskeletal radiologists for the presence of high signal within the facet articulations (bright facet response) on fast spin echo T2-weighted images. Results: Of the 630 lumbar facet articulations imaged (L3/L4 through L5/S1), 340 (54%) and 346 (55%) respectively, per examiner, did show a bright facet response. Interexaminer agreement with respect to the level and grading of a bright facet response was almost perfect with K ranging from 0.85 to 0.91 (SE, 0.06). Prevalence of bright facet responses averaged 40.5% at L5/S1, 56.5% at L3/L4, and 66.5% at the L4/L5 level. There was an association with degenerative facet and disk changes. Conclusion: The bright facet response was a common phenomenon on T2-weighted magnetic resonance imaging of the lumbar spine in these cases. There was sufficient agreement with respect to the presence and extent of the bright facet response to conclude that the examiners' determinations were not made by random chance. There exist sufficient repeatability and reliability that a single descriptive term can be applied to unify the bright facet response, the bright facet sign. (J Manipulative Physiol Ther 2008;3 1:593-601)