Lower Back Pain at 26: The MRI Finding Doctors Miss

🎯 A 26-year-old man with bilateral lower back pain and an almost-normal lumbar MRI. Almost. Here is the subtle facet finding that explains the symptoms. 00:00:00 Case: 26-Year-Old Male 00:00:28 Bilateral Lower Back Pain 00:01:18 T1 vs T2: Discs Look Fine 00:01:54 Axial View: Yellow Ligaments 00:02:05 Facet Joint Fluid Accumulation 00:03:48 STIR Sequence Findings 00:04:13 Interspinous Ligament Edema 00:05:45 Conclusion: Mild Disease In this lumbar spine MRI walkthrough, Dr. Galvani works through a young patient case where the discs look fine, the bones look fine, and yet the pain is real. Using T1, T2 and STIR sequences, we hunt down mild facet synovitis at L3-L4 and L4-L5, plus an inflamed interspinous ligament at L5-S1 — findings that are easy to overlook on a fast read but clinically meaningful. ✅ Why T1 is best for bone and anatomy while T2 reveals nerve roots and pathology ✅ How to spot fluid accumulation in facet joints on axial views ✅ Recognizing interspinous ligament edema on STIR sequences ✅ When 'mild disease' on imaging still justifies real patient pain ✅ How body habitus changes your interpretation of spinal overload 🩺 Perfect for radiology residents, MSK fellows, orthopedic trainees, physical therapists and medical students learning to read lumbar spine MRI systematically. 👍 LIKE if this case sharpened your search pattern 💬 COMMENT with your own approach to subtle facet findings 🔔 SUBSCRIBE for weekly live radiology reads and MRI case breakdowns --- 🎬 Full live session: https://youtube.com/live/mwNUtdPK8SY