Ultrasound allows visualization of soft tissues, nerves, and vessels (abnormal anatomy), which has the potential to improve the safety of atlanto-axial and atlanto-occipital joint injections by decreasing the incidence or by avoiding injury of nearby structures [5]

An atlanto-axial (AA) joint injection is an outpatient procedure for diagnosing and treating chronic upper neck pain and headache. This information sheet will explain what it is.

The atlanto-occipital (AO) and atlanto-axial (AA) joints are unique joints in the spine, connecting the cervical region to the base of the skull. The AA and AO joints are an often under-appreciated cause of pain and should be part of the differential diagnosis of cervical spine pain and occipital headaches.

Lateral atlanto-axial joint (AAJ) injection: AP view showing the needle (A) targeting the lateral third of the joint, and the contrast is contained within the joint space (Reproduced with permission from Ohio Pain and Headache Institute)

The atlanto-occipital (AO) and atlanto-axial (AA) joints are unique joints in the spine, connecting the cervical region to the base of the skull. The AA and AO joints are an often under-appreciated cause of pain, and should be part of the differential diagnosis of cervical spine pain and occipital headaches.