Xrayt2.pdf

Ministry of Higher Education and Scientific Research Al-Kitab University College of Medical Techniques Radiology and Ultrasonic .Dept second stage Radiographic Techniques AP PROJECTION—INTERNAL ROTATION SHOULDER (NONTRAUMA) DR ,KHUDHIER AHMED ALJOBOURY l BORAD IN DIAGNOSTIC RADIOLOGY Simple radi...

Ministry of Higher Education and Scientific Research Al-Kitab University College of Medical Techniques Radiology and Ultrasonic .Dept second stage Radiographic Techniques AP PROJECTION—INTERNAL ROTATION SHOULDER (NONTRAUMA) DR ,KHUDHIER AHMED ALJOBOURY l BORAD IN DIAGNOSTIC RADIOLOGY Simple radilogical anatomy First ,,bonny compartment which include 1-clavicle bone ,which consisting of three parts ,lateral part ,middle part ,,medial part ,,the lateral articulate with acromion which is part of scapula forming acromioclavicular joint ,and the medial third articulate with the sternum forming sternoclavicular joint , Second ,the scapula bone , Its triangular bonny compartment ,located posterior to the chest wall and main parts of it 1. Acromion which located at superior anterior aspect of the scapula 2. Glenoid cavity 3. Coracoid process ,project from the upper margin of scapula , Third ,,the hemerus bone which consisting of , Head 2. Neck 3. Greater tubercle 4. Lesser tubercle 1. Muscles which include Rotator cuff muscles , 1-supraspinatous muscle 2-infraspinatous muscle 3-subscapularis AP PROJECTION—INTERNAL ROTATION SHOULDER (NONTRAUMA) Clinical Indications • Fractures or dislocations of proximal humerus and shoulder girdle • Calcium deposits in muscles, tendons, or bursal structures • Degenerative conditions including osteoporosis and osteoarthritis Technical Factors • Minimum SID—40 inches (102 cm) • IR size—24 × 30 cm (10 × 12 inches), crosswise (or lengthwise to demonstrate entire humerus if injury includes proximal half of humerus) • Grid • Analog—70 to 75 kV range • Digital systems—75 to 85 kV range Shielding Shield all radiosensitive tissues outside region of interest. Patient Position Perform radiograph with the patient in an erect or supine position. (The erect position is usually less painful for patient, if condition allows.) Rotate body slightly toward affected side, if necessary, to place shoulder in contact with IR or tabletop. Part Position • Position patient to center scapulohumeral joint to center of IR. • Abduct extended arm slightly; internally rotate arm (pronate hand) until epicondyles of distal humerus are perpendicular to IR. Internal rotation—lateral. CR CR 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: • Lateral view of proximal humerus and lateral two-thirds of clavicle and upper scapula is demonstrated, including the relationship of the humeral head to the glenoid cavity. Position: • Full internal rotation position is evidenced by 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. Fracture greater tuberosity of humerus Fracture glenoid cavity Fracture of the neck of humerus Fracture of the clavicle Fracture of proximal humerus Internal fixation Fracture of proximal humerus Acromion fracture Which bone fracture ? \ \Which bone fracture ? \ Which bone fracture ? \ Which bone fracture ? \ Whats this condition \ Whats this condition ? \ So thanks Lecture 2 POSITIONING TERMINOLOGY Dr.Khudhir Ahmed Aljobouri ‫دﻛﺘﻮراه ﻓﻲ اﻻﺷﻌﺔ اﻟﺘﺸﺨﯿﺼﯿﺔ‬