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Atlanto-occipital Joint Pain: A Report of Three Cases and Description of an Intraarticular Joint Block Technique
  1. Paul Dreyfuss, M.D.*,
  2. James Rogers, M.D.,
  3. Susan Dreyer, M.D. and
  4. David Fletcher, M.D.§
  1. *From The Neuro-Skeletal Center, Tyler, Texas and the Department of Rehabilitation Medicine, University of Texas Health Science at San Antonio, San Antonio, Texas;
  2. Department of Anesthesiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas;
  3. Georgia Spine and Sports Physicians, Smyrna, Georgia and the Department of Rehabilitation Medicine, Emory University, Atlanta, Georgia; and
  4. §The Neuro-Skeletal Center
  1. Reprint requests: Paul Dreyfuss, M.D., The Neuro-Skeletal Center, 816 S. Fleishel, Tyler, TX 75701.


Background and Objectives The atlanto-occipital (AO) joint is a true, innervated synovial joint with the potential to cause pain.

Methods A detailed description of an AO joint injection technique is provided, as none was found on review of the literature.

Results Using this technique, three illustrative cases provide preliminary evidence that intraarticular injection of the AO joint may have both diagnostic and therapeutic value for the treatment of upper cervical pain and headaches.

Conclusions Although AO joint injections may prove to be an effective adjunct to more traditional forms of conservative treatment, additional prospective studies are needed to better define the role of intraarticular AO joint injections in the diagnosis and treatment of head and neck pain.

  • atlanto-occipital joint
  • fluoroscopy
  • anesthesia
  • anatomy
  • headaches
  • neck pain

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