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Radiography Techniques for Shoulder and Proximal Humerus
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Radiography Techniques for Shoulder and Proximal Humerus

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Questions and Answers

What is the recommended patient position for taking a radiograph of the shoulder?

  • Supine position only
  • Lateral decubitus position
  • Prone position
  • Erect or supine position (correct)

    • How should the arm be positioned for an AP projection of the shoulder?

  • Extend the arm and rotate it laterally
  • Flex the arm and rotate it medially
  • Abduct the arm and externally rotate it (correct)
  • Adduct the arm and internally rotate it

    • What is the recommended direction of the central ray (CR) for an AP projection of the shoulder?

  • Directed to the acromion process
  • Directed to 2.5 cm inferior to the coracoid process (correct)
  • Directed to the coracoid process
  • Directed to the humeral head

    • What is the minimum recommended source-to-image receptor distance (SID) for an AP projection of the shoulder?

    <p>100 cm</p> Signup and view all the answers

    How should the IR be collimated for an AP projection of the shoulder?

    <p>Collimate on 4 sides</p> Signup and view all the answers

    Why is it recommended to suspend respiration during exposure for an AP projection of the shoulder?

    <p>To reduce patient movement</p> Signup and view all the answers

    What is the recommended SID for the AP projection of the shoulder?

    <p>100 cm</p> Signup and view all the answers

    What is the main reason for shielding the pelvic area?

    <p>To reduce radiation exposure to the patient</p> Signup and view all the answers

    In the AP projection, how should the arm be positioned?

    <p>Abduct and internally rotate</p> Signup and view all the answers

    What is the purpose of suspending respiration during exposure?

    <p>To reduce motion artifacts</p> Signup and view all the answers

    What is the main purpose of collimation in the AP projection?

    <p>To reduce the X-ray beam size</p> Signup and view all the answers

    What is the recommended position for the patient during the AP projection?

    <p>Erect or supine</p> Signup and view all the answers

    What is the name of the method used in the inferosuperior axial projection?

    <p>Lawrence method</p> Signup and view all the answers

    What is one of the pathologic processes that can be demonstrated in the AP projection?

    <p>All of the above</p> Signup and view all the answers

    What is the orientation of the thumb in the exaggerated external rotation?

    <p>Pointed down and posteriorly</p> Signup and view all the answers

    What is the size of the IR in the inferosuperior axial projection?

    <p>18 x 24 cm</p> Signup and view all the answers

    What is the purpose of the vertical cassette holder in the inferosuperior axial projection?

    <p>To accommodate the double CR angle</p> Signup and view all the answers

    What is the recommended kV range for the inferosuperior axial projection?

    <p>70 ± 5 kV</p> Signup and view all the answers

    What should be avoided if a fracture or dislocation is suspected?

    <p>Forcing full abduction</p> Signup and view all the answers

    What is the purpose of the table in the technical factors?

    <p>To provide technique and dose information</p> Signup and view all the answers

    What is the position of the patient's arm in the Inferosuperior Axial Projection?

    <p>Abducted 90o from the body with the elbow flexed</p> Signup and view all the answers

    What is the direction of the Central Ray (CR) in the Inferosuperior Axial Projection?

    <p>25o anterior and 25o medial</p> Signup and view all the answers

    What is the minimum Source to Image Receptor Distance (SID) required for the Inferosuperior Axial Projection?

    <p>100 cm (40 inches)</p> Signup and view all the answers

    What is the purpose of collimating the X-ray beam in the Inferosuperior Axial Projection?

    <p>To limit the X-ray beam to the area of interest</p> Signup and view all the answers

    What is demonstrated by the AP Apical Oblique Projection (Trauma) using the Garth Method?

    <p>All of the above</p> Signup and view all the answers

    What is the size of the Image Receptor (IR) required for the AP Apical Oblique Projection (Trauma)?

    <p>18 x 24 cm (8 x 10 inches)</p> Signup and view all the answers

    Why is it essential to suspend respiration during exposure in the Inferosuperior Axial Projection?

    <p>To minimize motion artifacts</p> Signup and view all the answers

    What is the purpose of shielding the pelvic area in the Inferosuperior Axial Projection?

    <p>To reduce patient dose</p> Signup and view all the answers

    What is the recommended angle for the PA axial projection?

    <p>15o-20o caudal angle</p> Signup and view all the answers

    Why should shoulder and/or clavicle projections be completed first?

    <p>To rule out fractures</p> Signup and view all the answers

    What is the recommended IR size for AP projections?

    <p>35 x 43 cm (14 x 17 inches)</p> Signup and view all the answers

    What is the purpose of using 'with weight' and 'without weight' markers?

    <p>To compare joint separation with and without weights</p> Signup and view all the answers

    What is the recommended exposure factor for larger patients with a grid?

    <p>65-70 kV with screen</p> Signup and view all the answers

    Why is respiration suspended at the end of inhalation?

    <p>To elevate the clavicles</p> Signup and view all the answers

    What is the purpose of using a nongrid for AP projections?

    <p>To reduce grid lines on the image</p> Signup and view all the answers

    How should the cassette be placed for broad-shouldered patients?

    <p>Two 18 x 24 cm (8 x 10 inches) cassettes placed crosswise</p> Signup and view all the answers

    Study Notes

    AP Projection – External Rotation: Shoulder (Nontrauma)

    • AP Proximal Humerus
    • Shielding: shield pelvic area
    • Patient position: take radiograph with the patient in an erect or supine position
    • Part position: position patient to centre SHJ to centre of IR
    • Abduct extended arm slightly, then externally rotate arm (supinate hand) until epicondyles of distal humerus are parallel to IR
    • CR: directed to 2.5 cm inferior to coracoid process, minimum SID of 100 cm
    • Collimation: collimate on 4 sides, with lateral and upper borders adjusted to SHJ margins
    • Respiration: suspend respiration during exposure

    AP Projection – Internal Rotation: Shoulder (Nontrauma)

    • Lateral Proximal Humerus
    • Shielding: shield pelvic area
    • Patient position: take radiograph with the patient in an erect or supine position
    • Part position: position patient to centre SHJ to centre of IR
    • Abduct extended arm slightly, then internally rotate arm (pronate hand) until epicondyles of distal humerus are perpendicular to IR
    • CR: directed to 2.5 cm inferior to coracoid process, minimum SID of 100 cm
    • Collimation: collimate on 4 sides, with lateral and upper borders adjusted to SHJ margins
    • Respiration: suspend respiration during exposure

    Inferosuperior Axial Projection: Shoulder (Nontrauma)

    • Lawrence Method
    • Shielding: shield pelvic area
    • Patient position: take radiograph with the patient in an erect or supine position
    • Part position: position patient to centre SHJ to centre of IR
    • Abduct extended arm slightly, then externally rotate arm (supinate hand) until epicondyles of distal humerus are parallel to IR
    • CR: directed to 2.5 cm inferior to coracoid process, minimum SID of 100 cm
    • Collimation: collimate on 4 sides, with lateral and upper borders adjusted to SHJ margins
    • Respiration: suspend respiration during exposure
    • Pathology demonstrated: fracture and dislocation of proximal humerus, Hills-Sachs defect, osteoporosis, osteoarthritis
    • Technical factors: IR size 18 x 24 cm, crosswise, stationary grid, 70 ± 5 kV

    Inferosuperior Axial Projection: Shoulder (Nontrauma)

    • West Point Method
    • Shielding: shield pelvic area
    • Patient position: position patient prone on the table with the affected shoulder elevated approximately 7.5 cm from the table top
    • Part position: abduct arm 90° from body with elbow flexed to allow forearm to hang freely over the side of the table
    • Rotate head away from the affected side and place IR in vertical cassette holder and secure against the superior surface of the shoulder
    • CR: direct CR 25° anterior (down from horizontal) and 25° medial, passing through the mid SHJ, minimum SID of 100 cm
    • Collimation: collimate on 4 sides to area of affected shoulder
    • Respiration: suspend respiration during exposure

    AP Apical Oblique Projection: Shoulder (Trauma)

    • Garth Method
    • Pathology demonstrated: SHJ dislocation, glenoid fracture, Hill-Sachs lesions, ST calcification
    • Technical factors: IR size 18 x 24 cm, lengthwise, moving or stationary grid, digital IR, 75 ± 5 kV
    • Respiration: suspend respiration at end of inhalation

    AP and AP Axial Projections: Clavicle

    • Pathology demonstrated: clavicle fracture
    • Technical factors: IR size 18 x 24 cm, crosswise, moving or stationary grid, digital IR

    AP Projection: AC Joints

    • Bilateral with and without weights
    • Warning: shoulder and/or clavicle projections should be completed first to rule out fractures
    • Pathology demonstrated: ACJ separation
    • Technical factors: IR size 35 x 43 cm, crosswise, nongrid, 65 ± 5 kV with screen, 65-70 with grid on larger patients

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    Description

    This quiz covers radiography techniques and procedures for taking AP projections of the shoulder and proximal humerus, including patient positioning and shielding. Learn about the necessary settings and best practices for capturing high-quality images.

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