Lecture (10 )
Radiography of the shoulder Girdle Shoulder joint AP external rotation ( non trauma) AP internal rotation ( non trauma) AP Gleno- humeral joint Lateral Transthoracic Axial AP/ PA & AP axial clavicle Acromioclavicular joints
AP External rotation KvmAsFFD (cm)GridFocusCassette YesFine24x30 Exposure Factors Patient position Erect or Supine Part position Center coracoid process to cassette rotate patient slightly towards the affected side ●Adjust hand in External rotation to obtain an AP projection of proximal humerus ●Adjust hand in Internal rotation for lateral projection of proximal humerus
Central Ray Perpendicular Center Point 1 inch inferior to the Coracoid process Structures shown Internal rotation ( AP proximal humerus,2/3 of clavicle, humeral head in Relation to gelnoid cavity) External rotation ( AP proximal humerus,2/3 of clavicle, humeral head inRelation to gelnoid cavity)
Glenohumeral joint Exposure Factors KvmAsFFD (cm)GridFocusCassette NoFine18x24 cm YesFine18x24 cm Patient Position Erect or Supine Part position Rotate patient degrees towards affected side Dorsal surface of scapula parallel to film holder Place arm in normal anatomical position Humeral epicondyles equidistance from the film holder
Central Ray Perpendicular Center Point TO Gleno-humeral joint Structures shown Gleno-humeral joint AP Glenohumeral joint
Transthoracic Lateral ( Trauma ) ( For Fracture & dislocation ) KvmAsFFD (cm)GridFocusCassette YesFine 18x24 cm Exposure Factors Patient position Erect or Supine Part position Raised uninjured arm Rest hand of uninjured arm on head Elevate uninjured shoulder Adjust humerus between vertebral column and sternum Expose on gentle breathing if patient can Co-operate other wise suspend respiration
Central Ray Perpendicular Center Point Through the thorax to surgical neck Structures shown Lateral view of the proximal half of humerus and glenohumeral joint visualized through the thorax
Inferosuperior Axial Patient position Supine with shoulder raised about 2 inches From tabletop by placing support under arm an shoulder Part position Abduct arm 90 degrees if possible Rotate head towards opposite side Place vertical cassette as close to neck And support with sand bags Suspend respiration during exposure Central Ray degrees medially Center Point Horizontally to axilla
Structures shown Lateral view of the proximal humerus in relation to the scapulohumeral cavity