MSK ultrasound of the cervical spine

MSK ultrasound is used to scan the nerve roots and brachial plexus. MSK ultrasound can be used for diagnostic and interventional purposes. For localizing the nerve roots one makes use of the bony landmarks of the different cervical segmental levels. This article defined a set of potential, relevant, specific anatomical landmarks and validated them anatomically. As an example, the transverse processes of C6 and C7 are shown in the image at the bottom this post.

If one visualizes the transverse processes of C6 and C7 with MSK ultrasound. The anterior and posterior tubercle is part of C6 transverse proces anatomy. To find these C6 tubercles: Imagine placing the transducer sagitally on the ventral neck, for example on the thyroid cartilage. This is a 0º position of the transducer. Placing the transducer on the side of the neck, in the frontal plane, would be a 90º position of the transducer. To visualize the tubercles scan in a 85º position. To find C7, place the transducer in a 90º position to find the transverse proces. Sweep cranially/caudally to find the best depiction of the typical C6 and C7 bony landmarks (see image below). The nerve roots can typically be found close to the landmarks.

The tubercles of C6 and transverse proces of C7 are important anatomical bony landmarks of the cervical vertebrae in scanning with MSK ultrasound. Other anatomical landmarks that can be used in MSK ultrasound of the cervical spine are the mastoid process, the transverse process of C1, and the cervical laminae. Especially, the cervical dorsal laminae serve best as anatomical bony landmarks to reliably detect the cervical segmental levels in vivo. 

Video: Ultrasound-Guided Cervical Spine Injection

Video: The Brachial plexus made easy