Facet arthritis in pediatrics:
Case report
Abstract
Low back pain in children and adolescents is a common condition, with an annual prevalence ranging from 7% to 58%. It is more frequent between the ages of 13 and 15. It is expected that 10% to 30% of the healthy young population will experience an episode of low back pain by the time they reach adolescence(1). Most causes of low back pain are benign, but it is important to rule out potentially serious conditions such as infections.
Facet arthritis is a rare but potentially serious condition, with pediatric cases being infrequent. The diagnosis is generally delayed, and symptoms are often unclear, so a high level of suspicion is necessary; a complete physical examination is essential, along with laboratory and imaging studies where MRI plays a crucial role in the diagnosis. The first case was described by Halpin in 1987, and since then, around 100 publications have been reported, with 10 involving pediatric patients. It accounts for about 4% of vertebral infections, although it often goes unnoticed. The most frequent location is at the lumbar level. Hematogenous spread is the most
common route, although cases of direct inoculation have also been reported(2).
We will describe the case of a 5-year-old girl and her 5-year evolution with a diagnosis of L3-L4 left facet arthritis. Therapeutic guidelines will be presented based on a review of current literature.
Downloads
References
Altaf F, Heran MKS, Wilson LF. Back pain in children and adolescents. Bone Jt J. 2014;96 B(6):717–23.
Halpin DS, Gibson RD. Septic arthritis of a lumbar facet joint. J Bone Joint Surg Br. 1987;69(3):457–9.
Muffoletto AJ, Ketonen LM, Mader JT, Crow WN, Hadjipavlou AG. Hematogenous pyogenic facet joint infection. Spine (Phila Pa 1976). 2001;26(14):1570–6.
Heenan SD, Britton J. Septic arthritis in a lumbar facet joint: a rare cause of an epidural abscess. Neuroradiology. 1995;37(6):462–4.
Papaliodis DN, Roberts TT, Richardson NG, Lawrence JB. Spontaneous septic arthritis of the lumbar facet caused by methicillin-resistant Staphylococcus aureus in an otherwise healthy adolescent. Am J Orthop (Belle
Mead NJ). 2014;43(7):325–7.
Michel-Batôt C, Dintinger H, Blum A, Olivier P, Laborde F, BettembourgBrault I, et al. A particular form of septic arthritis: Septic arthritis of facet joint. Jt Bone Spine. 2008;75(1):78–83.
Saavedra-Lozano J, Falup-Pecurariu O, Faust SN, Girschick H, Hartwig N, Kaplan S, et al. Bone and Joint Infections. Pediatr Infect Dis J. 2017;36(8):788–99.
Zunino C, Vomero A, Pandolfo S, Gutiérrez C, Algorta G, Pírez MC, et al. Etiología y evolución de las infecciones osteo-articulares 2009-2015. Hospital Pediátrico del centro hospitalario Pereira Rossell, Uruguay. Rev Chil Infectol. 2017;34(3):235–42.
Romero María Cecilia, Mas Mariana, Giachetto Gustavo, Algorta Gabriela, Pírez María Catalina, Cúneo Alejandro et al . Etiología y presentación clínica de las infecciones osteoarticulares en niños hospitalizados en el Hospital Pediátrico del Centro Hospitalario Pereira Rossell 2003-2005. Rev. Méd. Urug. 2008;4(4):238-245.
Pandolfo S, Vomero A, Ambrosoni M, Zunino C, Algorta G, Giachetto G. Características de las infecciones osteoarticulares por Staphylococcus aureus en niños hospitalizados. Arch Pediatr Uruguay. 2013;84(S1):S42--S47.
Ishibe M, Inoue M, Saitou K. Septic arthritis of a lumbar facet joint due to pyonex. Arch Orthop Trauma Surg. 2001;121(1–2):90–2.
Nishimura Y, Ishida H, Shin N, Mori K, Yoshihara T, Kasubuchi Y, et al. Streptococcus pneumoniae-associated arthritis of a lumbar facet joint in a 4-year-old boy. Pediatr Int. 2004;46(1):101–3.
Smida M, Lejri M, Kandara H, Sayed M, Ben Chehida F, Ben Ghachem M. Septic arthritis of a lumbar facet joint: Case report and review of the literature. Acta Orthop Belg. 2004;70(3):290–4.
Mas-Atance J, Gil-García MI, Jover-Sáenz A, Curià-Jové E, Jové-Talavera R, Charlez-Marco A, et al. Septic arthritis of a posterior lumbar facet joint in an infant: A case report. Spine (Phila Pa 1976). 2009;34(13):465–8.
Prasad M, De Vere N. Spinal epidural abscess masquerading as an acute abdomen. Pediatr Neurol (Internet). 2014;50(5):540–1. Available from: http://dx.doi.org/10.1016/j.pediatrneurol. 2014.01.034
French R, Purushothaman B, Roysam GS, Lakshmanan P. Pediatric facet joint septic arthritis. Spine J (Internet). 2015;15(7):1686–8. Available from: http://dx.doi.org/10.1016/j.spinee. 2015.02.006
Le Hanneur M, Vidal C, Mallet C, Mazda K, Ilharreborde B. Unusual case of paediatric septic arthritis of the lumbar facet joints due to Kingella kingae. Orthop Traumatol Surg Res (Internet). 2016;102(7):959–61. Available from: http://dx.doi.org/10.1016/j.otsr.2016.05.019
García-Mata S, Hidalgo-Ovejero. Acute haematogenous septic arthritis of a lumbar facet joint in an otherwise healthy adolescent. An Sist Sanit Navar. 2019;42(2):221–5.
Copyright (c) 2026 Martin Espiga, Patricia Curbelo, Claudio Silveri, Maria Elena Pérez Carrera
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain their copyright and assign to the journal the right of first publication of their work, which will be simultaneously subject to the Creative Commons Attribution 4.0 International License. that allows sharing the work as long as the initial publication in this magazine is indicated.
