48 Questions
What is the recommended minimum SID for the AP projection—external rotation shoulder?
40 inches
In which position should the patient be for the radiograph?
Erect or supine
Where should the CR be directed for the AP projection—external rotation shoulder?
1 inch inferior to coracoid process
How should the arm be positioned for the AP projection—external rotation shoulder?
Abducted and externally rotated (supinated)
What is the purpose of suspending respiration during exposure?
To minimize motion artifacts
What anatomy is demonstrated in the AP projection—external rotation shoulder?
Proximal humerus, lateral two-thirds of clavicle, upper scapula
What is the essential image characteristic of the AP projection with the humerus in the lateral position?
The head of the humerus, the glenoid cavity, and the scapula
Where is the cassette positioned in the AP projection with the humerus in an oblique position?
Under the patient, with its upper border at least 5 cm above the shoulder
In which projection is it necessary to direct the primary beam caudally to project the head of the humerus?
AP projection with the humerus in an oblique position
What is demonstrated using Stryker’s position?
Deformity of the humeral head
How is the patient positioned in a lateral oblique ‘Y’ projection?
Unaffected shoulder raised to make an angle of approximately 60 degrees between trunk and cassette
What is centered for an AP projection with humerus in a lateral position?
Medial border of scapula
In which method does the patient lie supine on a trolley or X-ray table?
AP projection with humerus in oblique position
What angle is made between trunk and cassette in a lateral oblique ‘Y’ projection?
Approximately 60 degrees
Where is Stryker’s position used to demonstrate deformity?
Humerus head deformity
What angle is directed through center of axilla for Stryker's position?
10 degrees cranially
What is the recommended minimum SID for the AP projection—internal rotation shoulder?
40 inches
How should the patient be positioned for the AP projection—internal rotation shoulder?
Erect or supine position
Where should the CR be directed for the AP projection—internal rotation shoulder?
1 inch (2.5 cm) inferior to coracoid process
What anatomy is demonstrated in the AP projection—internal rotation shoulder?
Lateral view of proximal humerus and lateral two-thirds of clavicle and upper scapula
What is the purpose of suspending respiration during exposure?
To avoid motion blur in the image
What condition can be diagnosed using the AP projection—internal rotation shoulder?
Calcium deposits in muscles, tendons, or bursal structures
What is centered for an AP projection with humerus in a lateral position?
Scapulohumeral joint to center of IR
What angle is made between trunk and cassette in a lateral oblique 'Y' projection?
45 degrees
Where is Stryker’s position used to demonstrate deformity?
Proximal humerus and shoulder girdle
What is the main bone compartment that includes the clavicle bone?
Bonny compartment
Which part of the scapula articulates with the acromion to form the acromioclavicular joint?
Acromion
What is the main purpose of suspending respiration during exposure?
To reduce motion artifacts
Where is the coracoid process located?
Projecting from the upper margin of scapula
What part of the humerus bone articulates with the scapula at the glenoid cavity?
Head
Where does the medial part of the clavicle bone articulate to form a joint?
With sternum to form sternoclavicular joint
What is located at the superior anterior aspect of the scapula?
Acromion
Which bone consists of greater tubercle and lesser tubercle?
Humerus bone
What does the sagittal plane divide the body into?
Right and left sides
Which term describes movement toward the midline of the body or body part?
Adduction
What is the anatomical position?
Standing erect with arms by the side, feet together, and palms forward
What term describes movement away from the midline of the body or body part?
Abduction
Which bone articulates with the scapula at the glenoid cavity?
Humerus
In the antero-posterior position for an X-ray of the elbow joint, where is the cassette positioned?
Under the elbow joint
What is the essential image that should be demonstrated in an X-ray of the elbow joint?
Distal third of humerus and proximal third of radius and ulna
How is the patient positioned for a lateral projection of the elbow?
Seated alongside the table with affected side nearest to the table
What angle should be directed through the joint space for an X-ray of the elbow joint?
$90^{ ext{o}}$
What is centered for an antero-posterior projection with humerus in a lateral position?
Medial and lateral epicondyles
What is adjusted such that medial and lateral epicondyles are equidistant from the cassette in an antero-posterior position for an X-ray of the elbow joint?
Arm
How should the elbow be flexed for a lateral projection of the elbow?
To 90 degrees
Where is Stryker's position used to demonstrate deformity?
Shoulder joint
What does the sagittal plane divide the body into?
Left and right halves
What part of the scapula articulates with the acromion to form the acromioclavicular joint?
Acromion process
Study Notes
- The text describes various X-ray projection techniques for imaging the shoulder region.
- The instructions assume that the reader is a radiographic technician or medical professional.
- One common technique is the antero-posterior (AP) projection with the humerus in the lateral position.
- In this method, the patient stands or sits with the lateral aspect of the injured arm against an erect cassette. The unaffected shoulder is raised to make an angle of approximately 60 degrees between the trunk and the cassette.
- The horizontal central ray is directed towards the medial border of the scapula and centered to the head of the humerus.
- The essential image characteristics include the head of the humerus, the glenoid cavity, and the scapula.
- Another method involves taking an AP projection with the humerus in the oblique position. This technique is used when the shoulder cannot be examined in the erect position due to multiple trauma or immobility.
- The patient lies supine on the trolley or X-ray table. The arm is partially abducted and supinated. The cassette is positioned under the patient, with its upper border at least 5 cm above the shoulder.
- The vertical central ray is centered to the palpable coracoid process of the scapula, and it may be necessary to direct the primary beam caudally to project the head of the humerus.
- The essential image characteristics include the subacromial space, the proximal end of the humerus, the lateral aspect of the scapula, and the whole of the clavicle.
- In a lateral oblique ‘Y’ projection, the patient stands or sits with the lateral aspect of the injured arm against an erect cassette. The unaffected shoulder is raised to make an angle of approximately 60 degrees between the trunk and the cassette.
- The horizontal central ray is directed towards the medial border of the scapula and centered to the head of the humerus.
- The essential image characteristics include the head of the humerus, the glenoid cavity, and the scapula.
- The text also mentions a modified AP projection, known as the Stryker’s position, which is used to demonstrate a deformity of the humeral head.
- The patient lies supine on the X-ray table. The arm of the affected side is extended fully, and the elbow is then flexed to allow the hand to rest on the patient’s head.
- The central ray is angled 10 degrees cranially and directed through the center of the axilla to the head of the humerus and the center of the cassette.
- The essential image characteristics include the head of the humerus, the glenoid cavity, and the humeral head deformity.
Test your knowledge of the anatomy of the humerus shaft and its clinical indications for X-ray imaging. Explore key concepts such as patient positioning and clinical indications.
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