Podcast
Questions and Answers
During an AP shoulder projection with external rotation, what position should the patient's hand be in, assuming no contraindications?
During an AP shoulder projection with external rotation, what position should the patient's hand be in, assuming no contraindications?
- Palm resting against the thigh
- Supinated (correct)
- Back of hand resting on the hip
- Pronated
When performing an AP shoulder projection with neutral rotation, the epicondyles should be parallel with the plane of the IR.
When performing an AP shoulder projection with neutral rotation, the epicondyles should be parallel with the plane of the IR.
False (B)
For an AP shoulder projection, where should the central ray (CR) be directed?
For an AP shoulder projection, where should the central ray (CR) be directed?
1 inch inferior to the coracoid process
In an internal rotation AP shoulder projection, the __________ tubercle is seen in profile and pointing medially.
In an internal rotation AP shoulder projection, the __________ tubercle is seen in profile and pointing medially.
Match the shoulder projection with the position of the epicondyles relative to the image receptor (IR):
Match the shoulder projection with the position of the epicondyles relative to the image receptor (IR):
Which structure is best visualized in profile during an AP shoulder projection with external rotation?
Which structure is best visualized in profile during an AP shoulder projection with external rotation?
Rotating the arm for different AP shoulder projections is permissible even if a fracture is suspected.
Rotating the arm for different AP shoulder projections is permissible even if a fracture is suspected.
What anatomical landmark should be palpated to locate the correct centering point for the AP shoulder projection?
What anatomical landmark should be palpated to locate the correct centering point for the AP shoulder projection?
Flashcards
Shoulder AP Projection
Shoulder AP Projection
An imaging technique to visualize the shoulder joint.
External Rotation of Humerus
External Rotation of Humerus
Positioning the arm so the epicondyles are parallel to the IR.
Structures Shown - External Rotation
Structures Shown - External Rotation
Shows the greater tubercle of the humerus in anatomic position.
Neutral Rotation of Humerus
Neutral Rotation of Humerus
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Structures Shown - Neutral Rotation
Structures Shown - Neutral Rotation
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Internal Rotation of Humerus
Internal Rotation of Humerus
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Structures Shown - Internal Rotation
Structures Shown - Internal Rotation
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Evaluation Criteria - Internal Rotation
Evaluation Criteria - Internal Rotation
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Study Notes
Shoulder AP Projection - External, Neutral, Internal Rotation
- Key Considerations (Important): Do not have patient rotate arm if fracture or dislocation is suspected.
Positioning the Part:
- Center the shoulder joint to the midline of the grid.
- Center the IR 1 inch inferior to the coracoid process.
- CR perpendicular to a point 1 inch inferior to the coracoid process (palpate below clavicle, medial to humeral head).
External Rotation
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Patient Position: Supinate the hand (unless contraindicated) Slightly abduct and rotate arm so epicondyles parallel to IR plane. Externally rotate arm fully from neutral. This positions shoulder & humerus for true anatomical view.
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Structures Shown: Greater tubercle of the humerus in anatomical position, and scapulohumeral joint relationship.
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Evaluation Criteria: Humeral head in profile, greater tubercle in profile on lateral aspect of humerus, and scapulohumeral joint visualized with slight overlapping of humeral head on glenoid cavity.
Neutral Rotation
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Patient Position: Rest palm of hand against thigh. This slightly internally rotates humerus to a neutral position, placing epicondyles at 45° with IR plane.
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Structures Shown: Posterior supraspinatus insertion (may show small calcific deposits not otherwise visible).
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Evaluation Criteria: Greater tubercle partially superimposed on humeral head, humeral head in partial profile.
Internal Rotation
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Patient Position: Flex elbow, internally rotate arm, and rest back of hand on hip. Adjust arm so epicondyles are perpendicular to IR plane.
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Structures Shown: Proximal humerus in true lateral position. If arm abduction is sufficient, subscapular tendon insertion site can be seen.
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Evaluation Criteria: Lesser tubercle in profile pointing medially, greater overlap of humeral head on glenoid cavity, compared to external and neutral positions.
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Description
Radiographic positioning for AP shoulder projections with external, neutral, and internal rotation. Key considerations include patient positioning and centering the shoulder joint. Evaluated by visualization of the humeral head and greater tubercle.
