Podcast
Questions and Answers
What is the primary reason for performing an AP projection with internal rotation of the shoulder?
What is the primary reason for performing an AP projection with internal rotation of the shoulder?
- To assess the acromioclavicular joint for dislocations.
- To demonstrate the scapulohumeral joint and proximal humerus, specifically the lesser tubercle in profile. (correct)
- To evaluate the extent of osteoporosis in the shoulder girdle.
- To visualize fractures of the distal humerus.
Which technical factor is essential for an AP shoulder projection with internal rotation?
Which technical factor is essential for an AP shoulder projection with internal rotation?
- A short SID to enhance magnification.
- An IR size of 14 x 17 inches (35 x 43 cm) to include the entire humerus.
- A kVp range between 70 and 85 to provide sufficient penetration and contrast. (correct)
- Utilizing a moving grid to blur out bony structures.
During an AP shoulder projection with internal rotation, how should the patient's arm be positioned?
During an AP shoulder projection with internal rotation, how should the patient's arm be positioned?
- Adducted and internally rotated until the epicondyles are perpendicular to the IR.
- Extended and externally rotated, with the hand supinated.
- Abducted and externally rotated until the epicondyles are parallel to the IR.
- Extended and internally rotated until the epicondyles are perpendicular to the IR. (correct)
Where should the central ray (CR) be directed for an AP shoulder projection with internal rotation?
Where should the central ray (CR) be directed for an AP shoulder projection with internal rotation?
What radiographic finding indicates correct positioning for an AP shoulder projection with internal rotation?
What radiographic finding indicates correct positioning for an AP shoulder projection with internal rotation?
What is the recommended collimation for an AP shoulder projection with internal rotation?
What is the recommended collimation for an AP shoulder projection with internal rotation?
Which breathing instruction should be given to the patient during an AP shoulder projection with internal rotation?
Which breathing instruction should be given to the patient during an AP shoulder projection with internal rotation?
Which of the following is a clinical indication for performing an AP projection with internal rotation of the shoulder?
Which of the following is a clinical indication for performing an AP projection with internal rotation of the shoulder?
What is the minimum source-to-image receptor distance (SID) typically used for an AP shoulder projection?
What is the minimum source-to-image receptor distance (SID) typically used for an AP shoulder projection?
Which structure should be positioned to the center of the image receptor (IR) for an AP shoulder projection with internal rotation?
Which structure should be positioned to the center of the image receptor (IR) for an AP shoulder projection with internal rotation?
What positioning adjustment can be made to ensure the shoulder is in contact with the IR?
What positioning adjustment can be made to ensure the shoulder is in contact with the IR?
An AP shoulder radiograph with internal rotation demonstrates the lesser tubercle in profile. What does this indicate?
An AP shoulder radiograph with internal rotation demonstrates the lesser tubercle in profile. What does this indicate?
What should the radiographer do if a fracture or dislocation is suspected before performing an AP internal rotation shoulder?
What should the radiographer do if a fracture or dislocation is suspected before performing an AP internal rotation shoulder?
What is the primary purpose of shielding during radiographic procedures?
What is the primary purpose of shielding during radiographic procedures?
What image receptor (IR) size is recommended for an AP shoulder projection to demonstrate the proximal aspect of the humerus?
What image receptor (IR) size is recommended for an AP shoulder projection to demonstrate the proximal aspect of the humerus?
In an AP internal rotation shoulder radiograph, how does the outline of the greater tubercle appear?
In an AP internal rotation shoulder radiograph, how does the outline of the greater tubercle appear?
What aspect of image quality should be optimized during exposure for an AP internal rotation shoulder radiograph?
What aspect of image quality should be optimized during exposure for an AP internal rotation shoulder radiograph?
Which degenerative condition might be evaluated using an AP shoulder projection?
Which degenerative condition might be evaluated using an AP shoulder projection?
Why is it important to perform the AP shoulder projection in an erect position if the patient's condition allows?
Why is it important to perform the AP shoulder projection in an erect position if the patient's condition allows?
Which of the following structures is best visualized in profile in the AP internal rotation shoulder projection?
Which of the following structures is best visualized in profile in the AP internal rotation shoulder projection?
What is the primary reason for using a grid during an AP shoulder projection?
What is the primary reason for using a grid during an AP shoulder projection?
What projection demonstrates a lateral view of the proximal humerus?
What projection demonstrates a lateral view of the proximal humerus?
In the evaluation criteria, which structures are included when assessing the anatomy demonstrated?
In the evaluation criteria, which structures are included when assessing the anatomy demonstrated?
Which of the following is a concern if optimal exposure settings are not used?
Which of the following is a concern if optimal exposure settings are not used?
What is the appropriate action if a patient is unable to fully internally rotate their arm for the AP shoulder projection?
What is the appropriate action if a patient is unable to fully internally rotate their arm for the AP shoulder projection?
What is the primary goal of collimation in radiography?
What is the primary goal of collimation in radiography?
Why is it necessary to center the scapulohumeral joint to the center of the image receptor?
Why is it necessary to center the scapulohumeral joint to the center of the image receptor?
What is the most important consideration regarding patient safety when performing an AP shoulder projection on a patient who has a known shoulder dislocation?
What is the most important consideration regarding patient safety when performing an AP shoulder projection on a patient who has a known shoulder dislocation?
What is the significance of visualizing soft tissue detail when evaluating an AP shoulder radiograph?
What is the significance of visualizing soft tissue detail when evaluating an AP shoulder radiograph?
From an evaluation standpoint, what specific bony landmark should be assessed in relation to the humeral head?
From an evaluation standpoint, what specific bony landmark should be assessed in relation to the humeral head?
Which positioning error is indicated if the lesser tubercle is not visualized in full profile on the medial aspect of the humeral head?
Which positioning error is indicated if the lesser tubercle is not visualized in full profile on the medial aspect of the humeral head?
If the scapula is excessively superimposed over the humerus, what adjustment should a radiographer consider?
If the scapula is excessively superimposed over the humerus, what adjustment should a radiographer consider?
What is the purpose of slightly abducting the extended arm during the AP internal rotation shoulder projection?
What is the purpose of slightly abducting the extended arm during the AP internal rotation shoulder projection?
Which of the following should be clearly demonstrated on an AP shoulder radiograph with internal rotation to ensure diagnostic quality?
Which of the following should be clearly demonstrated on an AP shoulder radiograph with internal rotation to ensure diagnostic quality?
What does the term 'landscape' orientation refer to when discussing image receptor (IR) placement for an AP shoulder projection?
What does the term 'landscape' orientation refer to when discussing image receptor (IR) placement for an AP shoulder projection?
Flashcards
Clinical indications for AP shoulder (internal rotation)
Clinical indications for AP shoulder (internal rotation)
Fractures or dislocations of the proximal humerus and shoulder girdle.
Calcium deposits on AP shoulder (internal rotation)
Calcium deposits on AP shoulder (internal rotation)
Deposits in muscles, tendons, or bursal structures.
Degenerative conditions on AP shoulder (internal rotation)
Degenerative conditions on AP shoulder (internal rotation)
Conditions including osteoporosis and osteoarthritis.
Minimum SID for AP shoulder (internal rotation)
Minimum SID for AP shoulder (internal rotation)
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IR size for AP shoulder (internal rotation)
IR size for AP shoulder (internal rotation)
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kVp range for AP shoulder (internal rotation)
kVp range for AP shoulder (internal rotation)
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Shielding for AP shoulder (internal rotation)
Shielding for AP shoulder (internal rotation)
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Patient position for AP shoulder (internal rotation)
Patient position for AP shoulder (internal rotation)
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Part position for AP shoulder (internal rotation)
Part position for AP shoulder (internal rotation)
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Arm position for AP shoulder (internal rotation)
Arm position for AP shoulder (internal rotation)
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CR Direction for AP shoulder (internal rotation)
CR Direction for AP shoulder (internal rotation)
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Recommended collimation for AP shoulder (internal rotation)
Recommended collimation for AP shoulder (internal rotation)
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Respiration for AP shoulder (internal rotation)
Respiration for AP shoulder (internal rotation)
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Anatomy demonstrated on AP shoulder (internal rotation)
Anatomy demonstrated on AP shoulder (internal rotation)
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Position of AP shoulder (internal rotation)
Position of AP shoulder (internal rotation)
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Greater tubercle on AP Shoulder (internal rotation)
Greater tubercle on AP Shoulder (internal rotation)
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Exposure quality for AP shoulder (internal rotation)
Exposure quality for AP shoulder (internal rotation)
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Study Notes
- AP Projection-Internal Rotation: Shoulder (Nontrauma), Lateral Proximal Humerus
Clinical Indications
- Fractures or dislocations of proximal humerus and shoulder girdle can be assessed using this projection
- Useful for visualizing calcium deposits in muscles, tendons, or bursal structures
- Aids in the evaluation of degenerative conditions, including osteoporosis and osteoarthritis
Technical Factors
- Minimum SID (Source-to-Image Distance) is 40 inches (100 cm)
- Use a 10 x 12 inches (24 x 30 cm) image receptor (IR), landscape (or portrait to demonstrate proximal aspect of humerus)
- Utilize a grid
- kVp range is 70-85
Shielding
- Shield radiosensitive tissues outside the region of interest
Patient Position
- Perform radiograph with patient in an erect or supine position
- Erect position is usually less painful for patient, if condition allows
- Rotate body slightly toward affected side; if necessary, place shoulder in contact with IR or tabletop
Part Position
- Position patient to center scapulohumeral joint to center of IR
- Abduct extended arm slightly and internally rotate arm (pronate hand) until epicondyles of distal humerus are perpendicular to IR
Central Ray (CR)
- CR is perpendicular to IR, directed to 1 inch (2.5 cm) inferior to coracoid process
Recommended Collimation
- Collimate on four sides, with lateral and upper borders adjusted to soft tissue margins
Respiration
- Suspend respiration during exposure
Evaluation Criteria
- Anatomy Demonstrated: Shows lateral view of proximal humerus and lateral two-thirds of clavicle and upper scapula, including the relationship of the humeral head to the glenoid cavity
- Position: Full internal rotation position is evidenced by the lesser tubercle visualized in full profile on the medial aspect of the humeral head; an outline of the greater tubercle should be visualized superimposed over the humeral head; collimation to area of interest
- Exposure: Optimal density (brightness) and contrast with no motion demonstrate clear, sharp bony trabecular markings with soft tissue detail visible for possible calcium deposits
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