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Questions and Answers
What is the recommended minimum SID for the AP projection—external rotation shoulder?
What is the recommended minimum SID for the AP projection—external rotation shoulder?
- 30 cm
- 40 inches (correct)
- 75 kV range
- 24 × 30 cm
In what position should the patient be for the radiograph?
In what position should the patient be for the radiograph?
- Sitting
- Erect or supine (correct)
- Prone
- Lateral
How should the arm be positioned for the AP projection—external rotation shoulder?
How should the arm be positioned for the AP projection—external rotation shoulder?
- Fully extend the arm; keep hand pronated
- Abduct extended arm slightly; externally rotate arm (supinate hand) (correct)
- Keep arm close to the body; internally rotate arm
- Flex the arm at 90 degrees; keep hand neutral
Where should the CR be directed for the AP projection—external rotation shoulder?
Where should the CR be directed for the AP projection—external rotation shoulder?
What anatomy is demonstrated in the AP projection of proximal humerus?
What anatomy is demonstrated in the AP projection of proximal humerus?
What is evidenced by greater tubercle visualized in full profile on the lateral aspect of the proximal humerus in the AP projection?
What is evidenced by greater tubercle visualized in full profile on the lateral aspect of the proximal humerus in the AP projection?
In an antero-posterior X-ray of the humerus shaft, how should the arm be positioned?
In an antero-posterior X-ray of the humerus shaft, how should the arm be positioned?
Where should the central ray be directed for a lateral X-ray of the humerus shaft?
Where should the central ray be directed for a lateral X-ray of the humerus shaft?
What is the essential image characteristic for an antero-posterior X-ray of the humerus shaft?
What is the essential image characteristic for an antero-posterior X-ray of the humerus shaft?
How should the patient be positioned for an antero-posterior X-ray of the humerus shaft?
How should the patient be positioned for an antero-posterior X-ray of the humerus shaft?
What is the clinical indication for a lateral X-ray of the humerus shaft?
What is the clinical indication for a lateral X-ray of the humerus shaft?
Where is the cassette positioned for an antero-posterior X-ray of the humerus shaft?
Where is the cassette positioned for an antero-posterior X-ray of the humerus shaft?
How should the forearm be immobilized for an antero-posterior X-ray of the humerus shaft?
How should the forearm be immobilized for an antero-posterior X-ray of the humerus shaft?
What is the purpose of the lateral X-ray projection for the shoulder?
What is the purpose of the lateral X-ray projection for the shoulder?
How is the AP projection different when taken with the patient lying supine on the trolley?
How is the AP projection different when taken with the patient lying supine on the trolley?
When is a lateral oblique 'Y' projection used?
When is a lateral oblique 'Y' projection used?
What does the antero-posterior (modified) – Stryker’s projection demonstrate?
What does the antero-posterior (modified) – Stryker’s projection demonstrate?
What forms the acromioclavicular joint?
What forms the acromioclavicular joint?
Where is the scapula bone located?
Where is the scapula bone located?
What are the main parts of the scapula bone?
What are the main parts of the scapula bone?
What consists of the humerus bone?
What consists of the humerus bone?
What does lateral projection evaluate?
What does lateral projection evaluate?
What does AP projection demonstrate when taken with patient lying supine on trolley?
What does AP projection demonstrate when taken with patient lying supine on trolley?
What is the clinical indication for the AP projection—internal rotation shoulder (nontrauma)?
What is the clinical indication for the AP projection—internal rotation shoulder (nontrauma)?
Where should the central ray (CR) be directed for the AP projection—internal rotation shoulder?
Where should the central ray (CR) be directed for the AP projection—internal rotation shoulder?
What is evidenced by full internal rotation position in the AP projection—internal rotation shoulder?
What is evidenced by full internal rotation position in the AP projection—internal rotation shoulder?
What is the recommended minimum Source-to-Image Distance (SID) for the AP projection—internal rotation shoulder?
What is the recommended minimum Source-to-Image Distance (SID) for the AP projection—internal rotation shoulder?
What does the lateral view of proximal humerus and lateral two-thirds of clavicle demonstrate in the AP projection—internal rotation shoulder?
What does the lateral view of proximal humerus and lateral two-thirds of clavicle demonstrate in the AP projection—internal rotation shoulder?
What should be done with respiration during exposure for the AP projection—internal rotation shoulder?
What should be done with respiration during exposure for the AP projection—internal rotation shoulder?
How should the patient's arm be positioned for the AP projection—internal rotation shoulder?
How should the patient's arm be positioned for the AP projection—internal rotation shoulder?
What forms an outline visualized superimposed over the humeral head in full internal rotation position in AP projection—internal rotation shoulder?
What forms an outline visualized superimposed over the humeral head in full internal rotation position in AP projection—internal rotation shoulder?
What is shielded outside region of interest for AP projection—internal rotation shoulder?
What is shielded outside region of interest for AP projection—internal rotation shoulder?
Where should patient be positioned for radiograph during AP projection—internal rotation shoulder?
Where should patient be positioned for radiograph during AP projection—internal rotation shoulder?
What is the main purpose of the lateral X-ray projection for the shoulder?
What is the main purpose of the lateral X-ray projection for the shoulder?
Where is the acromion located in relation to the scapula bone?
Where is the acromion located in relation to the scapula bone?
Which joint does the lateral part of the clavicle articulate with?
Which joint does the lateral part of the clavicle articulate with?
What is the function of the coracoid process of the scapula bone?
What is the function of the coracoid process of the scapula bone?
Which part of the scapula bone is located at the superior anterior aspect?
Which part of the scapula bone is located at the superior anterior aspect?
What bones make up the elbow joint?
What bones make up the elbow joint?
How should the arm be positioned for an antero-posterior X-ray of the humerus shaft?
How should the arm be positioned for an antero-posterior X-ray of the humerus shaft?
Where is the cassette positioned for an antero-posterior X-ray of the humerus shaft?
Where is the cassette positioned for an antero-posterior X-ray of the humerus shaft?
What is the essential image for an antero-posterior X-ray of the humerus shaft supposed to demonstrate?
What is the essential image for an antero-posterior X-ray of the humerus shaft supposed to demonstrate?
What position should the patient be in for a lateral projection of elbow?
What position should the patient be in for a lateral projection of elbow?
How should the elbow be positioned for a lateral projection of elbow?
How should the elbow be positioned for a lateral projection of elbow?
Where should the central ray be centered for antero-posterior X-ray of elbow joint?
Where should the central ray be centered for antero-posterior X-ray of elbow joint?
How is the limb immobilized during antero-posterior X-ray of elbow joint?
How is the limb immobilized during antero-posterior X-ray of elbow joint?
What does lateral projection of elbow demonstrate?
What does lateral projection of elbow demonstrate?
Where should the central ray be directed for lateral projection of elbow?
Where should the central ray be directed for lateral projection of elbow?
What is the anatomical position?
What is the anatomical position?
What type of plane divides the body into right and left sides?
What type of plane divides the body into right and left sides?
What movement term describes 'away from the midline of the body or body part'?
What movement term describes 'away from the midline of the body or body part'?
Which term means 'closer to the origin of the body part or the point of attachment of a limb to the trunk'?
Which term means 'closer to the origin of the body part or the point of attachment of a limb to the trunk'?
'Hyperextension' refers to:
'Hyperextension' refers to:
What is the term for 'movement toward the midline of the body or body part'?
What is the term for 'movement toward the midline of the body or body part'?
Which term means 'towards or at front of the body'?
Which term means 'towards or at front of the body'?
What does 'superficial' mean in anatomical terms?
What does 'superficial' mean in anatomical terms?
What is 'transverse plane' also known as?
What is 'transverse plane' also known as?
'Lateral' refers to being:
'Lateral' refers to being:
'Axial plane' divides the body into:
'Axial plane' divides the body into:
Study Notes
- The text describes various X-ray projection techniques for imaging the shoulder region, including the lateral, antero-posterior (AP), and oblique projections.
- The lateral projection is used to evaluate the glenohumeral joint space, the head of the humerus, the greater and lesser tuberosities, and the lateral aspect of the scapula. The patient stands with the affected shoulder against an erect cassette, the arm is abducted and rotated outwards, and the cassette is positioned to include the superior border of the scapula. The horizontal central ray is directed towards the medial border of the scapula and centred to the head of the humerus.
- The AP projection is used to demonstrate the glenoid cavity and joint space when the body of the scapula is parallel to the cassette. In the erect position, the patient stands with the affected shoulder against the cassette and is rotated approximately 30 degrees to bring the plane of the glenoid fossa perpendicular to the cassette. The cassette is positioned so that its upper border is at least 5 cm above the shoulder. The horizontal central ray is centred to the palpable coracoid process of the scapula and collimated to an 18-24 cm cassette. The image should clearly show the joint space between the head of the humerus and the glenoid cavity, and the head, greater and lesser tuberosities, lateral aspect of the scapula, and the distal end of the clavicle.
- In cases where the patient cannot be examined in the erect position due to multiple trauma or immobility, the AP projection is taken with the patient lying supine on the trolley. The upper border of the cassette is positioned at least 5 cm above the shoulder, and the vertical central ray is centred to the palpable coracoid process of the scapula. The subacromial space should be visible and the proximal end of the humerus, the lateral aspect of the scapula, and the whole of the clavicle need to be included.
- A lateral oblique ‘Y’ projection is taken when the arm is immobilized and no abduction of the arm is possible. The patient stands or sits with the lateral aspect of the injured arm against an erect cassette, and the horizontal central ray is directed towards the medial border of the scapula and centred to the head of the humerus. This projection is used in recurrent dislocation, along with the antero-posterior with the humerus lateral, antero-posterior with the humerus oblique, and infero-superior projections.
- The antero-posterior (modified) – Stryker’s projection is used to demonstrate a deformity of the humeral head. The patient lies supine on the X-ray table, and the arm of the affected side is extended fully and the elbow then flexed to allow the hand to rest on the patient’s head. The line joining the epicondyles of the humerus remains parallel to the tabletop, and the centre of the cassette is positioned 2.5 cm superior to the head of the humerus. The central ray is angled 10 degrees cranially and directed through the centre of the axilla to the head of the humerus and the centre of the cassette. This projection is used in the diagnosis of various shoulder conditions.
- The text also mentions the simple anatomical structure of the shoulder region, including the clavicle, scapula, and humerus bones, and their respective joints. The lateral part of the clavicle articulates with the acromion, forming the acromioclavicular joint, while the medial third articulates with the sternum, forming the sternoclavicular joint. The scapula bone has a triangular shape and is located posterior to the chest wall. Its main parts include the acromion, glenoid cavity, and coracoid process. The humerus bone consists of the head, neck, greater tubercle, and lesser tubercle.
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Test your knowledge of the anatomy and X-ray positioning of the humerus shaft with this quiz. Learn about the clinical indications and techniques for capturing X-rays of the humerus shaft.
