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Feasibility of Ultrasound Guided Atlanto-occipital Joint Injection
Sun Jae Won1, U-Young Lee, Sei Un Cho
1Department of Rehabilitation Medicine, Yeouido St. Mary's Hospital, Seoul 150-713, Korea.
Objective:
To evaluate the feasibility of ultrasound guided atlanto-occipital joint injection.
Method:
Six atlanto-occipital joints of three cadavers were examined. Cadavers were placed in prone position with their head slightly rotated towards the contra-lateral side. The atlanto-occipital joint was initially identified with a longitudinal ultrasound scan at the midline between occipital protuberance and mastoid process. Contrast media 0.5cc was injected into the atlanto-occipital joint using an in-plane needle approach under ultrasound guide. The location of the needle tip and spreading pattern of the contrast was confirmed by fluoroscopic evaluation.
Results:
After ultrasound guided atlanto-occipital joint injection, spreading of the contrast media into the joint was seen in all the injected joints in the anterior-posterior fluoroscopic view.
Conclusion:
The ultrasound guided atlanto-occipital injection is feasible. The ultrasound guided injection by Doppler examination can provide a safer approach to the atlanto-occipital joint.

