Technique of Injection

The patient is in the prone position. The approach is parallel to the head of the rib and slightly ascending in order to avoid the transverse process of the vertebra (Fig. 13). Injected contrast material immediately flows in a linear, semicircular fashion between the head of the rib and the

FIGURE 11 Diagrammatic coronal representation of the costovertebral joint.

FIGURE 12 Diagrammatic axial representation of the joint of the head of the rib and the costotransverse joint.

FIGURE 13 Needle placement into a joint of the head of a rib (oblique view).

vertebral body facet. A small synovial recess is present at the inferior aspects of the neck and head of the rib (Fig. 14). Use of nonionic contrast material is recommended to avoid complications of unexpected injection into the thoracic spinal canal.

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Dealing With Back Pain

Dealing With Back Pain

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