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Shoulder Clavicle...

Position:Shoulder, Clavicle, AC Joints, Scapula

QuestionAnswer
Shoulder Girdle Articulations 1.Scapulohumeral/Glenohumeral 2.Acromioclavicular "AC" 3.Sternoclavicular "SC"
Shoulder Routine 1.AP with lateral rotation 2.AP with external rotation 3.Inferosuperior Axial "Lawrence Method"
Trauma Shoulder Routine 1 AP (neutral rotation) 2.Scapular Y Method 3.Transthoracic Method "Lawrence Method"
Optional Shoulder Views 1.West Point Method 2.Grashey Method 3.Neer Method
Shoulder exams will always use: 10"x12" film---cw SID 40"
AP with External Rotation (Shoulder) Position:external rotation Projection:anteroposterior CR:1" inferior coracoid process
AP with External Rotation (Shoulder) image *Greater tubercle in profile on the lateral aspect, this will determine if the humeral epicondyles were parallel *Entire clavicle is shown
AP Neutral Rotation (Shoulder) Position:Neutral rotation Projection:Anteroposterior CR:1" inferior to coracoid process
AP Neutral Rotation (Shoulder) image *Greater and Lesser tubercle will be superimposed on the humeral head *Entire clavicle is shown
AP with Internal Rotation (Shoulder) Position:Internal rotation Projection:Anteroposterior CR:1" inferior to coracoid process
AP with Internal Rotation (Shoulder) image *Lesser tubercle in profile on the medial aspect, this will determine if the humeral epicondyles were perpendicular *Entire clavicle is shown
Inferosuperior Axial (Shoulder) Position:Lawrence Method Projection:Inferosuperior Axial CR:Horizontal through the axilla
Inferosuperior Axial (Shoulder) image *Open the Scapuloumeral Joint space *Lesser tubercle *Anterior anatomy will be superior
Superoinferior Axial (Shoulder) Position:Seated with arm abducted, hand pronated Projection:Superoinferior Axial CR:5-15 toward elbow Location: at the shoulder joint
Scapular Y Method Position:Scapular Y Method Projection:PA Oblique CR:Scapulohumeral Joint
Scapular Y Method vs. Transthoracic Lateral Shoulder Scapular Y Method is for dislocation Transthoracic Lateral is for fractures
Over vs. Under Rotation for Scapular Y Method Over rotated: lateral(thicker) border is beside the ribs Under rotated: medial(thinner) border is beside the ribs
Scapular Y Method (Trauma) Position:RPO or LPO Projection:AP Oblique CR:Scapulohumeral Joint
West Point Method Position:West Point Method Projection:Inferosuperior Axial CR:Enters 5" inferior & 1 1/2" medial acromion, exits glenoid cavity *Dual tube CR angle 25 degrees both medial & anterior
West Point Image *Best show scapulohumeral rim *Patients with chronic dislocation
Grashey Method Position:Grashey Method Projection:AP Oblique CR:Glenoid Cavity (2" medial & 2" inferior to superolateral border
Grashey Method Image *Done to show the glenohumeral joint space **Shows glenoid cavity in profile
Neer Method Position:Neer Method Projection:Tangential CR:10-15 caudal, enters superior humeral head
Neer Method Image *Shows posterior surface of acromion *Humeral head is below AC joint **Supraspinatus outlet
AP Clavicle Position:Erect Posterior/Supine Projection:Anteroposterior CR:Mid shaft of clavicle
AP and PA Clavicle Images *Shows entire clavicle AC to SC joint *Medial half is superimposed **Lateral half is above scapula
PA Clavicle Position:Erect Anterior/Supine Projection:Posteroanterior CR:Exiting mid shaft clavicle
Which is preferred AP or PA for clavicles? Because the PA decreases the OID which increases the detail.
AP Axial Clavicle Position:Erect/Posterior/Supine Projection:Anteroposterior Axial CR:Erect/Supine:15-30 cephalic//Lordotic:0-15 cephalic//both at the mid shaft
PA Axial Clavicle Position:Erect Anterior/Supine Projection:Posteroanterior Axial CR:15-30 caudal, Exiting mid shaft
AP and PA Axial Clavicle Images *Clavicle is above the ribs *Horizontal *Medial end is overlap on the ribs
Acromioclavicular Joint Series Position:Erect Posterior Projection:Anteroposterior CR:MSP at level of AC joints *Two exposures--one with weights, one without
Scapula Routine 1.Anteroposterior 2.Lateral
AP Scapula Position:Supine/erect Posterior Projection:Anteroposterior CR:2" inferior coracoid
AP Scapula Image *Lateral portion free *Acromion process to inferior angle
Lateral Scapula Position:Lateral Projection:Mediolateral CR:Mid medial border of scapula *Arm across anterior of body
Lateral Scapula Image *Lateral & medial border superimposed *Scapula away from ribs *Humerus away from scapula
Anatomy: Shoulder--surfaces Anterior: subscapular fossa, coracoid process ***Posterior: crest of spine, acromion process, supraspinous and infraspinous fossa
Anatomy: Shoulder--borders (3 borders) superior border with scapular notch **medial border (thinner) **lateral border (thicker)
Anatomy: Shoulder--angles superior, inferior, lateral
Anatomy: Clavicle sternal extremity, body, acromial extremity
Created by: mandy91lou
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