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Fig. 17 | Insights into Imaging

Fig. 17

From: A practical guide for performing arthrography under fluoroscopic or ultrasound guidance

Fig. 17

a Diagrammatic representation of the lumbar facet joints with transverse (B) and sagittal sections (C). b The classical posterolateral approach represented in blue can be impeded by the curved orientation and degenerative changes of the joint. c A posterior approach targeting the inferior recess may be an easier alternative. d The inferior recess can be enlarged by placing a pillow under the patient’s abdomen in order to reduce the physiological lordosis. e The target is the medial and inferior aspect of the pedicle projection (indicated by yellow circles at L5). f The needle is inserted until bone contact and the adequate position is confirmed by opacification of the joint space. g Oblique views are not required with this approach and are only displayed here for a better understanding of the anatomy

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