Orthostatic Low Back Pain and Radiculopathy in a Professional Athlete with a Lumbar Synovial Facet Cyst: A Case Report

Background: Lumbar synovial facet cysts are commonly asymptomatic. Intermittent orthostatic symptoms associated with positional nerve root compression signs due to a synovial facet cyst have not yet been described. We report a case of a 38-year-old professional athlete with a lumbar synovial facet cyst causing intermittent orthostatic/positional symptoms. Methods: A case report. Results: Following the diagnosis made by magnetic resonance imaging, the patient underwent fluoroscopy-guided cyst aspiration with immediate relief of his symptoms. Within two weeks the patient had complete resolution of his symptoms and was fit to return to play. Conclusion: Orthostatic/positional back pain, limb weakness, and paresthesia should raise the possibility of a synovial facet cyst. Aspiration may allow early resolution of symptoms and early return to play in professional athletes.