Shoulder Radiography Quiz

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Questions and Answers

Which part of the scapula does the coracoid process project from?

Upper margin (correct)

Lower margin

Lateral border

Medial border

In radiographic terms, what should the CR be directed to in an AP external rotation shoulder projection?

Acromion process

Lesser tubercle

Greater tubercle

Coracoid process (correct)

Which of the following is NOT a part of the humerus bone?

Lesser tubercle

Trochlea (correct)

Head

Neck

What is the patient position recommended for an AP external rotation shoulder projection?

Erect position Signup and view all the answers

What should be parallel to the IR in an external rotation AP shoulder projection?

Epicondyles of distal humerus Signup and view all the answers

What is the approximate location of the coracoid process in relation to the clavicle?

Inferior to the lateral portion of the clavicle Signup and view all the answers

How can full external rotation be confirmed in an AP projection of the proximal humerus?

Greater tubercle visible in full profile on the lateral aspect of the proximal humerus Signup and view all the answers

In radiographic evaluation, what indicates optimal exposure for assessing bone density?

Clear, sharp bony trabecular markings Signup and view all the answers

Which anatomical structure is primarily examined in a radiograph to assess a possible calcium deposit?

Supraspinatus muscle Signup and view all the answers

In an AP projection of the proximal humerus, what position should the lesser tubercle be in for proper alignment?

Superimposed over the humeral head Signup and view all the answers

In an AP PROJECTION—EXTERNAL ROTATION SHOULDER X-ray, how should the patient's arm be positioned?

Flexed at the elbow and resting on the head Signup and view all the answers

What should be parallel to the tabletop in an AP PROJECTION—EXTERNAL ROTATION SHOULDER X-ray?

Line joining the epicondyles of the humerus Signup and view all the answers

Where should the centre of the cassette be positioned in an AP PROJECTION—EXTERNAL ROTATION SHOULDER X-ray?

2.5 cm superior to the head of the humerus Signup and view all the answers

Which part of the scapula is located at the superior anterior aspect?

Acromion Signup and view all the answers

What is the name of the joint formed by articulation between the lateral part of the clavicle and acromion?

Acromioclavicular joint Signup and view all the answers

Which bones need to be included in a lateral oblique 'Y' projection of the shoulder?

Humerus, scapula, clavicle Signup and view all the answers

What will be in profile when the arm is supinated in a lateral oblique 'Y' projection?

Greater tuberosity Signup and view all the answers

In a recurrent dislocation, which projection is used to demonstrate a deformity of the humeral head?

Antero-posterior (modified) - Stryker's Signup and view all the answers

How should the patient be positioned for a lateral oblique 'Y' shoulder projection?

Standing or sitting with the lateral aspect of the injured arm against an erect cassette Signup and view all the answers

Where should the X-ray beam be directed in a lateral oblique 'Y' shoulder projection?

Toward the medial border of the scapula and centered to the head of the humerus Signup and view all the answers

Study Notes

Scapula and Humerus Anatomy

The coracoid process projects from the superior border of the scapula.
The humerus bone consists of several parts; however, the correct identification of these parts is necessary to distinguish the bone structure effectively.

Radiographic Projections

In an AP external rotation shoulder projection, the central ray (CR) should be directed to the glenohumeral joint (approximately 1 inch inferior to the coracoid process).
Recommended patient position for an AP external rotation shoulder projection involves the arm being externally rotated, with the palms facing outward.
When achieving full external rotation in the AP projection of the proximal humerus, the greater tubercle must be visualized in profile.

Positioning Considerations

The humerus should be parallel to the image receptor (IR) in an external rotation AP shoulder projection.
The cassette center must be positioned to coincide with the glenohumeral joint during the AP projection.

Coracoid Process Location

The coracoid process is located superior and anterior to the clavicle.

Anatomical Structures in Radiographs

In assessing potential calcium deposits, the primary focus is on the supraspinatus tendon or the area surrounding the greater tubercle of the humerus.
Optimal exposure in radiographic evaluations is indicated by outlining bony margins and demonstrating appropriate contrast.

Shoulder Joint and Positioning

The acromioclavicular joint is formed through the articulation between the lateral part of the clavicle and acromion.
The lateral oblique 'Y' projection of the shoulder requires inclusion of the humerus and scapula for comprehensive evaluation.
In a lateral oblique 'Y' projection, when the arm is supinated, the greater tubercle appears in profile.

Deformities and Projections

For recurrent shoulder dislocation, the axillary projection is typically used to visualize the humeral head deformity.
The patient should be placed in a neutral position for the lateral oblique 'Y' shoulder projection, with the scapula perpendicular to the IR.
In a lateral oblique 'Y' projection, the X-ray beam should be directed to the mid-scapula, approximately at the level of the glenohumeral joint.

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Description

Test your knowledge on the external rotation shoulder radiography procedure, focusing on the clinical indications and technical factors. This quiz covers information on fractures, dislocations, calcium deposits, and degenerative conditions related to the shoulder girdle.