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Shoulder/Thorax

RadTech 108

QuestionAnswer
Shoulder AP *10x12, 40"SID *upright preferred, ctr shoulder jt to midline of grid, IR positioned @ 1" INFERIOR to the coracoid process, body of scapula is parallel with the IR
Shoulder AP-External Rotation *abduct arm slightly and rotate it so the epicondyles are parallel with the plane of the IR *supinate hand
Shoulder AP-Neutral Rotation *rest palm of the hand against the thigh, rolls the humerus slightly internal or NEUTRAL *places epicondyles @ 45 degrees with the plane of the IR
Shoulder AP-Internal Rotation *somewhat flex the elbow, rotate the arm internally and res the back of the hand on the hip *epicondyles are perpendicular to the plane of the IR
Central Ray and Respiration for Shoulder X-rays Respiration- suspend CR- perpendicular to a point 1" inferior to the coracoid process *Close collimation
Shoulder AP Oblique- Grashey Method *35-45 degrees posterior oblique position *affected shoulder closer to IR *CR-perpendicular to glenoid cavity, enters 2" medial and inferior to superolateral border of shoulder
Shoulder Joint-Inferosuperior Axial (lawrence method) *abduct the arm of the affected side @ a rt angle to the body *place IR against the shoulder as close to the neck as possible *CR-horizontally through the axilla to the region of the AC articulation, b/t 15-30 degrees
Shoulder Joint- Superioinferior Axial *8x10 *seated at end of table, Place IR near end of table and parallel with long axis *have pt lean laterally over the IR until the shoulder is over the midpoint of the IR *flex elbow 90 degrees *CR-angled 5-15 degrees through the shoulder jt
Clavicle AP *upright *center the clavicle to midline of IR, place arms along sides of body, shoulders in same plane, center clavicle to IR *CR-perpendicular to midshaft of the clavicle
Clavicle PA *clavicle is closer to IR (reduces OID) CR-exits midshaft of clavicle
Clavicle AP Axial *center IR to midshaft of clavicle, pt faces X-ray tube *CR-cephalic angle 15-30 degrees, collimation necessary
AC Joints (Pearson) *upright required b/c supine will reduce dislocation if present *arms hanging by side unsupported, 2 exposures with weightsand w/o *CR-perpendicular to midline of body at level of AC joints for Bilateral Image
Scapula AP *10x12 *Upright preferred, center affected scapula to midline of grid, abduct are to a rt angle with body, no rotation, top of IR 2"above the top of shoulders *CR-perpendicular to midscapular area @ 2"INFERIOR to coracoid process
Scapula Lateral (RAO/LAO) *45-60 degrees rotation from the plane of IR *flex elbow and place back of the hand on small of back *CR-perpendicular to the midmedial border of the protruding scapula
Sternum PA Oblique *SID=30" *facing upright bucky or prone, thorax is rotated just enough to prevent super imposition of vertebrae and sternum *top of IR 1 1/2 " above jugular notch *CR-perpendicular to IR entering at level T-7 @ 1" lateral to midsagittal plane
Sternum Lateral *72"SID *lateral position (standing or seated), rotate shoulders posteriorly and have the pt lock the hands behind the back *CR- perpendicular to IR and enters lateral border of midsternum
Ribs PA projection *Upright *bilateral ribs- IR @ 1 1/2" above the upper border of the shoulders *full inspiration *CR-@ level t-7
Ribs AP projection *upright facing tube *IR lengthwise 1 1/2" above the upper border of the shoulders *palms outward rested on hips *CR-perpendicular to center of IR
Ribs Axillary AP Oblique *upright *pts body @ 45 degree (rpo/lpo) *abduct arm of affected side and elevate away from the body *center IR with top 1 1/2" above shoulder and lower at level of iliac crest *CR-center of IR
Ribs Axillary PA Oblique *upright *position pts body at 45 degrees *affected side away from IR *CR-perpendicular to IR
Sternoclavicular Joints PA *10x12 *center IR @ the level of the spinous process of T-3 *CR- center of IR and level of T-3
Sternoclavicular Joints PA Oblique *seated upright or prone *affected side adjacent to IR *position pt at enough of an oblique angle to project the vertebrae well behind the SC jt. closest to the IR (10-15 degrees) *CR-Level of T-2 or T-3, @ 3" distal to the vertebral prominens
Created by: gsmith0141
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