Humerus Views in Radiology

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Questions and Answers

What is the primary purpose of using the cranial angle of 10-15 degrees cephalad during transthoracic lateral projections?

To prevent superimposition of the shoulders (correct)

To visualize the outline of the humerus shaft

To enhance the visibility of the scapulohumeral joint

To ensure the humeral head is aligned with the glenoid cavity

Which position should the arm be in during the AP neutral rotation view of the humerus?

Externally rotated

Internally rotated

In neutral position (correct)

Elevated above the head

When evaluating the transthoracic lateral humerus projection, what should be adequately visualized?

The greater tubercle

Superimposed epicondyles

The surgical neck of the humerus

The relationship between the humeral head and glenoid cavity (correct)

Which of the following indicates a correct method for performing a transthoracic lateral projection?

Patient standing with the affected side against the image receptor Signup and view all the answers

Which part of the humerus is visualized when labeling anatomy in a lateral view?

Superimposed epicondyles Signup and view all the answers

What is the main function of the clavicle and scapula in the shoulder girdle?

To connect the upper limb to the trunk Signup and view all the answers

Which border of the scapula is nearest to the axilla?

Lateral (Axillary) border Signup and view all the answers

Which structure is referred to as the thickest part of the scapula?

Lateral angle (head) Signup and view all the answers

What is the function of the subscapular fossa located on the anterior surface of the scapula?

Surface attachment for shoulder muscles Signup and view all the answers

How does the lateral view of the scapula resemble a letter?

L Signup and view all the answers

Which part of the scapula forms the posterior boundary and includes the spine?

Dorsal surface Signup and view all the answers

The acromion projects over which part of the skeleton?

Head of the humerus Signup and view all the answers

What is the significance of the suprascapular notch?

Partially forms the coracoid process Signup and view all the answers

What is the primary reason for performing an AP Axial projection of the clavicle?

To obtain a clearer view of the midclavicle Signup and view all the answers

Which projection should be utilized for patients with thick shoulders and chest during a clavicle examination?

15-20˚ caudal Signup and view all the answers

What type of injury is indicated by AC joint separation?

Partial or complete tear of the AC ligament Signup and view all the answers

In individuals, how does the clavicle typically differ between genders?

Females have shorter and less curved clavicles Signup and view all the answers

What is a common cause of acromioclavicular dislocation?

Fall leading to upper body impact Signup and view all the answers

What is the purpose of suspending respiration during clavicle imaging?

To reduce motion blur and improve image clarity Signup and view all the answers

Which routine projection is NOT typically used for imaging the clavicle?

Lateral Signup and view all the answers

What does a normal axillary view of the AC joints help assess?

Integrity of the coracoclavicular ligament Signup and view all the answers

What position should the arm be in for the AP External Rotation of the shoulder?

Arm slightly abducted and externally rotated Signup and view all the answers

Which structure is located anteriorly in relation to the glenoid cavity?

Coracoid Signup and view all the answers

What is the crucial criterion for the AP Internal Rotation projection?

Epicondyles must be perpendicular to the image receptor Signup and view all the answers

Which projection requires the patient to rotate their body 35-45 degrees toward the affected side?

AP Oblique Projection (Grashey method) Signup and view all the answers

For the Inferosuperior Axial Projection, what is the correct direction of the central ray (CR)?

Medially 25-30 degrees Signup and view all the answers

What positioning consideration is necessary for imaging above 10 cm?

Use of a grid Signup and view all the answers

In the AP Neutral Rotation projection, what is the placement of the arm?

Arm at side in 'as is' position Signup and view all the answers

What does the Scapular Y Lateral projection primarily assess?

Humeral head and glenoid cavity superimposition Signup and view all the answers

Which projection is specifically used for demonstrating the supraspinatus outlet region?

Supraspinatus Outlet (Neer method) Signup and view all the answers

Which evaluation criterion specifies the position of the greater tubercle for the external rotation projection?

Profiled laterally Signup and view all the answers

Which joint is located between the acromion and the clavicle?

Acromioclavicular joint Signup and view all the answers

Which part of the scapula is the glenoid cavity associated with?

Body Signup and view all the answers

What are the names of the two neck regions of the proximal humerus?

Anatomical neck and Surgical neck Signup and view all the answers

Which structure separates the greater and lesser tubercles of the humerus?

Intertubercular sulcus Signup and view all the answers

Which muscle attaches at the deltoid tuberosity of the humerus?

Deltoid muscle Signup and view all the answers

What is the term for the rough elevation on the body of the humerus?

Deltoid tuberosity Signup and view all the answers

Which angles of the scapula are identified in anatomical terminology?

Medial, Superior, and Inferior Signup and view all the answers

The greater tubercle is primarily associated with which muscle attachment?

Supraspinatus muscle Signup and view all the answers

Study Notes

Humerus Views

Erect or Supine Views include Transthoracic Lateral, AP Neutral Rotation, and AP External Rotation
Transthoracic Lateral View - Humerus, relationship between humeral head and glenoid cavity should be visualized. Outline of humerus shaft should be visible, no motion.
AP Neutral Rotation View - Humerus, SID 40, same as AP view but arm is left in a neutral position (not rotated).
AP External Rotation View - Humerus, SID 40, grid, patient erect or supine. Abduct extended arm slightly, externally rotate arm until epicondyles are parallel to IR. CR 1 inch inferior to coracoid process. Greater tubercle profiled laterally, scapulohumeral centered, proximal humerus, upper scapula, and clavicle visualized, optimal exposure factors.
AP Internal Rotation View - Humerus, SID 40, grid, patient erect or supine. Internally rotate arm until epicondyles are perpendicular to IR. CR 1 inch inferior to coracoid process. Lesser tubercle profiled medially, scapulohumeral joint centered, proximal humerus, upper scapula, and clavicle visualized, optimal exposure factors.

Shoulder/Scapula Anatomy

Shoulder Girdle - Consists of 2 bones (clavicle and scapula). The function of the two bones is to connect the upper limb to the trunk (axial skeleton).
Scapula - Forms the posterior part of the shoulder girdle, flat triangular bone.
- Borders - Superior (uppermost margin), Lateral (Axillary - border nearest axilla), Medial (Vertebral - border near the vertebrae).
- Angles - Superior (high - medial corner), Inferior (most inferior portion), Lateral (head - sometimes called head of the scapula, thickest part, ends laterally in a shallow depression called the glenoid cavity).
Shoulder Joint (Glenohumeral Joint) - Formed by the glenoid cavity (fossa) of the scapula and the head of the humerus.
Scapula Anterior View - Neck (constricted area between the head and body of the scapula), Body (arched in shape for strength, thin flat lower portion - wing or ala), Costal (Ventral) Surface (anterior surface of the scapula, costal means ribs- large depression on the anterior side known as Subscapular fossa).
Scapula Anterior View (Continued) - Acromion, Coracoid process.
Scapula Posterior View - Prominent structure - spine (starts at the vertebral border as a smooth area and continues laterally to end at the acromion). Separates the posterior surface into the Infraspinous Fossa and Supraspinous Fossa.
Scapula Lateral View - Looks like the letter "Y"
- Upper portion of the "Y" - Acromion (extends superior and posteriorly in relation to the glenoid cavity) and Coracoid (located anteriorly in relation to the joint or glenoid cavity).
- Lower portion of the "Y" - Body of the scapula.

Shoulder Positioning

Positioning Considerations - SID 40, Grid (greater than 10 cm), remove anything that could cause artifacts, suspend respiration.
External Rotation - Greater tubercle profiled laterally, scapulohumeral joint centered.
Internal Rotation - Lesser tubercle profiled medially, scapulohumeral joint centered.
Neutral Rotation - Greater tubercle superimposed.
AP - Greater tubercle profiled laterally.
Lateral - Lesser tubercle profiled medially, or Greater tubercle superimposed.

Shoulder

Clinical Indications - Degenerative conditions (Osteoporosis, Osteoarthritis), Hill-Sachs defect, fractures and dislocations, bursitis.
Nontrauma Routine Projections - AP External Rotation, AP Internal Rotation.
Trauma Routine Projections - AP Neutral Rotation, PA Oblique (Scapular Y Lateral).
Nontrauma Special Projections - Inferosuperior Axial (Lawrance Method), AP Oblique (Grashey Method).
Trauma Special Projections - Supraspinatus Outlet (Neer Method).

Shoulder Projections:

AP - SID 40, grid, patient erect or supine, center clavicle to IR, CR midclavicle, respiration suspend at end of inhalation.
AP Axial - SID 40, same as AP, angle CR 15-30º cephalad, CR midclavicle, suspend on inhalation.
Inferosuperior Axial (Lawrence Method) - SID 40, patient supine, shoulder raised 2 inches from tabletop, rotate head toward opposite side, abduct arm 90 degrees from body, externally rotate arm with palm up. CR directed medially 25-30º, centered to axilla and humeral head.
AP Oblique (Grashey Method) - SID 40, grid, erect or supine, rotate body 35-45º toward affected side (posterior oblique). CR centered to scapulohumeral joint.
PA Oblique (Scapular Y Lateral) - SID 40, grid, erect or supine, rotate patient into anterior oblique 45-60º. Palpate the superior angle of the scapula & AC joint articulation. Rotate patient until two points are perpendicular to IR.
Supraspinatus Outlet (Neer Method) - SID 40, rotate into anterior oblique 45-60º, CR angle 10-15º caudal centered to pass through humeral head.

Clavicle Anatomy

Clavicle Anatomy (Continued)- Size and shape differ between males and females. Female - shorter and less curved. Male - Thicker and more curved, most curved in heavily muscled men.
Clinical Indications - AC Joint separation (trauma resulting in partial or complete tear of the AC or coracoclavicular (CC) ligament), Acromioclavicular Dislocation (distal clavicle displaced superiorly, most commonly caused by a fall).
Routine Projections: - AP or PA, AP Axial or PA Axial.

Clavicle Projections:

AP - SID 40, erect or supine, center clavicle to IR, CR midclavicle, respiration suspend at end of inhalation.
AP Axial - SID 40, same as AP, angle CR 15-30º cephalad, CR midclavicle, suspend on inhalation.

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Description

Test your knowledge on the various views of the humerus, including Transthoracic Lateral, AP Neutral Rotation, and AP External and Internal Rotation. Understand the positioning, CR placement, and visualization details for each view. Perfect for radiology students and professionals seeking to refine their skills.