C1-2 arthrography.

OBJECTIVE: To describe the technique of C1-2 arthrography and recommend it as a suitable treatment for pain due to C1-2 abnormalities.

MATERIALS AND METHODS: One hundred patients with the following conditions were studied: cervical pain or neuralgia without radiographic changes (group 1, n = 23), osteoarthritis (group 2, n = 37), rheumatoid arthritis (group 3, n = 23), ankylosing spondylarthritis (group 4, n = 5) and diverse conditions (group 5, n = 12). The technique consists of lateral puncture of the posterior aspect of the C1-2 joint with a 20-gauge needle under fluoroscopic control, arthrography using 1 ml contrast medium, and a 1-ml long-acting steroid injection subsequently.

RESULTS: The articular cavity has an anterior and a posterior recess. Sometimes the posterior recess is large. In 18% of cases the contralateral joint also opacifies.

CONCLUSIONS: C1-2 arthrography appears to be an efficient and safe technique for the treatment of upper cervical pain due to C1-2 articular disorders.