C1-2 facet joint arthropathy with injection

Case contributed by Henry Knipe
Diagnosis certain


Six months of high left neck pain.

Patient Data

Age: 80 years
Gender: Male



Band-like uptake at the base of the dens in keeping with a known partially healed fracture. Focal uptake at left C1-2 facet joint. Further focal uptake at the right C2/C3 facet joint, C3/4 endplates, and right sternoclavicular joint.

Intra-articular injection of the left C1-2 facet joint (patient prone).

Case Discussion

C1-2 facet (lateral atlanto-axial) joint injections require some extra consideration due the course of the vertebral arteries at this level. Evaluation of prior imaging to assess the vertebral artery course should be performed, although at this level the vertebral artery is usually anterior or lateral to the C1-2 facet joint. Serious adverse events from these injections appear rare.

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