title: Presence and extent of severe facet joint osteoarthritis are associated with back pain in older adults.
abstract: OBJECTIVE
  To determine whether the presence and extent of severe lumbar facet joint osteoarthritis (OA) are associated with back pain in older adults, accounting for disc height narrowing and other covariates.
  
  
  METHODS
  Two hundred and fifty-two older adults from the Framingham Offspring Cohort (mean age 67 years) were studied. Participants received standardized computed tomography (CT) assessments of lumbar facet joint OA and disc height narrowing at the L2-S1 interspaces using four-grade semi-quantitative scales. Severe facet joint OA was defined according to the presence and/or degree of joint space narrowing, osteophytosis, articular process hypertrophy, articular erosions, subchondral cysts, and intraarticular vacuum phenomenon. Severe disc height narrowing was defined as marked narrowing with endplates almost in contact. Back pain was defined as participant report of pain on most days or all days in the past 12 months. We used multivariable logistic regression to examine associations between severe facet joint OA and back pain, adjusting for key covariates including disc height narrowing, sociodemographics, anthropometrics, and health factors.
  
  
  RESULTS
  Severe facet joint OA was more common in participants with back pain than those without (63.2% vs 46.7%; P = 0.03). In multivariable analyses, presence of any severe facet joint OA remained significantly associated with back pain (odds ratio (OR) 2.15 [95% confidence interval (CI) 1.13-4.08]). Each additional joint with severe OA conferred greater odds of back pain [OR per joint 1.20 (95% CI 1.02-1.41)].
  
  
  CONCLUSIONS
  The presence and extent of severe facet joint OA on CT imaging are associated with back pain in community-based older adults, independent of sociodemographics, health factors, and disc height narrowing.
authors: VA Puget Sound Healthcare System, Seattle, WA 98108, USA. pradeep.suri@va.gov
authors: P
authors: P
authors: Suri
authors: D J
authors: DJ
authors: Hunter
authors: J
authors: J
authors: Rainville
authors: A
authors: A
authors: Guermazi
authors: J N
authors: JN
authors: Katz
mesh_terms: D000368:Aged; D001416:Back Pain / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D055013:Osteoarthritis, Spine / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012307:Risk Factors; D012720:Severity of Illness Index; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging*
keywords: Arthritis; Intervertebral disc; Lumbar; Spondylosis; Zygapophyseal
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