RADIOLOGIC EVALUATION PRIOR TO RIT/PROLOTHERAPY
Plain radiographs are of limited diagnostic value in painful pathology of the connective tissue; however, they may detect:
- Structural or positional osseous abnormalities
- Anterior or posterior listhesis on lateral views (flexion, extension)
- Degenerative changes in general and deformity of zygapophyseal articulation (Browner, et al., 1998; Harris, et al., 1981; Resnick, 1995; Watkins, 1996.)
Videofluoroscopy or digital motion radiography is currently a valuable diagnostic method in evaluating painful hyper-mobility and instability due to post-traumatic and degenerative pathology of capsular and axial ligaments. Evaluation of certain axial and peripheral joints in motion affords a non-invasive opportunity to identify specific segments responsible for nociception. At the upper cervical levels, this technology is capable of identifying excessive motions at atlanto occipital, lateral, and median atlanto axial joints, and, indirectly, pathology of their respective fibrous articular capsules and periarticular ligaments. Capsule-related pathology with hypo- and hyper-mobility can be identified and documented in caudally situated cervical zygapophyseal articulations
Posterior listhesis of C3 on C4 during extension
indentified with digital motion radiography.
This was not identified with plain flexion, extension radiography.
(Images acquired utilizing Visualizer 2000 from VF-Works, Inc.
Modified by Tracey Slaughter.)