Unusual facet cyst containing struvite and hydroxyapatite.
This case report describes a patient with severe back pain and radiculopathy. She was found to have a facet cyst within the lumbar spine that appeared to contain calcium on MRI and CT. Upon aspiration the cyst was found to contain calcium ammonium phosphate (struvite) and calcium phosphate (hydroxyapatite). Ammonia production in the presence of urease-producing bacteria is responsible for the production of struvite in the human body. We postulate that there was a prior infection of the facet with urease-producing bacteria, thus accounting for the production of the struvite within the facet cyst.
Grantham
M
M
Department of Musculoskeletal Radiology, Cleveland Clinic Foundation,  OH 44195, USA.
Richmond
B
B
D017886:Durapatite / Q000032:analysis*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D017616:Magnesium Compounds / Q000032:analysis*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010710:Phosphates / Q000032:analysis*; D011859:Radiography; D013122:Spinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D013130:Spinal Stenosis / Q000175:diagnosis / Q000209:etiology; D000069877:Struvite; D013581:Synovial Cyst / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism
D017616:Magnesium Compounds; D010710:Phosphates; D017886:Durapatite; D000069877:Struvite