Assessment of atlantoaxial rotation: how accurate is clinical measurement? a comparative study of cervical range of motion using MRI and standard orthopedic techniques

Purpose Measurement of neck rotation is currently reliant on radiologic imaging. Given the radiation exposure for CT imaging and the additional inconvenience for the patients, an alternative assessment is needed. Goniometers are comfortably to use and easy to access, also for private consulting. The aim of this study was the assessment of whether a handheld goniometer can be used for accurately measuring the rotation of C1-C2. Methods Clinical measurement of rotation was taken in flexed position of the neck. As comparison functional MRI was used. The measured rotation of C1-C2 was compared to identify the accuracy of the goniometer, in comparison to functional MRI scan. Results Analysis of accuracy using a goniometer and dynamic MRI to assess C1-2 axial rotation showed significant differences for absolute values, but not regarding the percentage of rotation compared to total neck rotation. Conclusion The goniometer is exact to impartially determine the percentage contribution of C1-2 rotation to total neck rotation.