Shoulder Girdle- pt 2
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| True or false? Do not have patient rotate shoulder if fx or dislocation is suspected. | True
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| IR for AP projection of shoulder: external, neutral & internal rotation humerus | 24 x 30 cm ↔
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| Location of IR for AP projection of shoulder: external rotation | scapula ‖ w/ plane of IR; shoulder joint CTR to IR @ 1" ↓ to coracoid process
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| Location of IR for AP projection of shoulder: neutral rotation | scapula ‖ w/ IR; shoulder joint CTR to IR @ 1" ↓ to coracoid process
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| Location of IR for AP projection of shoulder: internal rotation | scapula ‖ w/ IR; shoulder joint CTR to IR @ 1" ↓ to coracoid process
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| Patient position for AP projection of shoulder: external rotation | upright* or supine; supinate hand & slightly abduct arm ∴ epicondyles ‖ w/ IR
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| Patient position for AP projection of shoulder: neutral rotation | upright* or supine; hand against thigh ∴ epicondyles @ 45° w/ IR
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| Patient position for AP projection of shoulder: internal rotation | upright* or supine; internally rotate arm & rest back of hand on hip ∴ epicondyles ⊥ w/ IR
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| CR for AP projection of shoulder: external, internal & neutral rotation | ⊥ @ 1" (2.5 cm) ↓ to coracoid process
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| Respiration for AP projection of shoulder: external, internal & neutral rotation | Suspend
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| Area of interest for AP projection of shoulder: external rotation | bony & soft structures of shoulder & proximal humerus; greater tubercle in profile
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| Area of interest for AP projection of shoulder: neutral rotation | bony & soft structures of shoulder & proximal humerus; humeral head in partial profile
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| Area of interest for AP projection of shoulder: internal rotation | bony & soft structures of shoulder & proximal humerus; lesser tubercle in profile
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| What are the Inferosuperior Axial projections of the shoulder joint also known as? | Lawrence method & Rafert modification
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| IR for Inferosuperior Axial shoulder joint, Lawrence method & Rafert modification | 10 x 12" (24 x 30 cm) grid ↔, in vertical position against superior shoulder
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| Position of patient for Inferosuperior Axial shoulder joint, Lawrence method | supine w/ 3" (7.6 cm) ↑ of head, shoulders & elbow; external rotation of affected side humerus @ ⊾ to body
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| Position of patient for Inferosuperior Axial shoulder joint, Rafert modification | supine w/ 3" (7.6 cm) ↑ of head, shoulders & elbow; exaggerated external rotation of affected side humerus w/ 45° hand (thumb ↓)
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| Location of IR for Inferosuperior Axial shoulder joint, Lawrence method & Rafert modification | IR supported vertically against shoulder & as close as possible to neck, w/ patient's head turned away
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| wedge-shaped compression fx on articular surface of humeral head; located on posterolateral humeral head | Hill-Sachs defect
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| CR for Inferosuperior Axial shoulder joint, Lawrence method | horizontally thru axilla to AC region; medial ∠ ↑ if abduction ↑; often medial 15-30°
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| CR for Inferosuperior Axial shoulder joint, Rafert modification | horizontally thru axilla to AC region @ medial 15°
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| Respiration for Inferosuperior Axial shoulder joint, Lawrence method & Rafert modification | Suspend
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| Area of interest for Inferosuperior Axial shoulder joint, Lawrence method & Rafert modification | proximal humerus, SH joint, lateral coracoid process & AC joint
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| What is the AP oblique projection of the shoulder joint & glenoid cavity, RPO/LPO also known as? | Grashey method
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| IR for AP oblique shoulder/glenoid cavity, RPO/LPO, Grashey method | 8 x 10" (18 x 24 cm) ↔
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| Location of IR for AP oblique shoulder/glenoid cavity, RPO/LPO, Grashey method | IR CTR to SH joint, 2" (5 cm) medial & 2" (5 cm) ↓ to the superolateral border of the shoulder
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| Patient position for AP oblique shoulder/glenoid cavity, RPO/LPO, Grashey method | upright* or supine; scapula ‖ w/ IR; pt rotated 35-45° toward affected side (↑ if supine); affected arm slightly abducted w/ palm on abdomen
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| CR for AP oblique shoulder/glenoid cavity, RPO/LPO, Grashey method | ⊥ @ 2" (5 cm) medial & 2" (5 cm) ↓ to superolateral border of shoulder
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| Respiration for AP oblique shoulder/glenoid cavity, RPO/LPO, Grashey method | Suspend
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| Area of interest for AP oblique shoulder/glenoid cavity, RPO/LPO, Grashey method | joint space btwn humeral head & glenoid cavity; SH joint
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| What is the variation of the tangential projection of the proximal humerus & intertubercular groove also known as? | Fisk modification, or Fisk's technique
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| IR for Tangential proximal humerus, intertubercular groove & Fisk modification | 8 x 10" (18 x 24 cm)
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| Location of IR for Tangential proximal humerus, intertubercular groove | IR vertical against superior shoulder
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| Location of IR for Tangential proximal humerus, intertubercular groove, FISK MODIFICATION | Pt holds IR against forearm
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| Patient position for Tangential proximal humerus, intertubercular groove | supine: 10-15° posterior (↓ from horizontal) to long axis of humerus
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| Patient position for Tangential proximal humerus, intertubercular groove, FISK MODIFICATION | standing or seated; pt leans fwd w/ forearm on table & vertical humerus 10-15° over IR
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| CR for Tangential proximal humerus, intertubercular groove | 10-15° posterior (↓ from horizontal) to long axis of humerus
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| CR for Tangential proximal humerus, intertubercular groove, FISK MODIFICATION | ⊥ to IR w/ vertical humerus @ 10-15°
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| Respiration for Tangential proximal humerus, intertubercular groove & Fisk modification | Suspend
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| Area of interest for Tangential proximal humerus, intertubercular groove & Fisk modification | intertubercular groove
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| What is the Transthoracic Lateral projection, Ⓡ or Ⓛ, of shoulder also known as? | Lawrence method
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| IR for Transthoracic lateral shoulder, Lawrence method, Ⓡ or Ⓛ | 24 x 30 cm ↕
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| Location of IR for Transthoracic lateral shoulder, Lawrence method, Ⓡ or Ⓛ | IR CTR to surgical neck of AFFECTED humerus
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| Patient position for Transthoracic lateral shoulder, Lawrence method, Ⓡ or Ⓛ | supine or upright*, seated or standing; pt ↑ uninjured arm w/ forearm on head & shoulder ↑ as much as possible
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| CR for Transthoracic lateral shoulder, Lawrence method, Ⓡ or Ⓛ | Per to midcoronal @ surgical neck; or 10-15° cephalad if pt unable to ↑ unaffected shoulder
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| Respiration for Transthoracic lateral shoulder, Lawrence method, Ⓡ or Ⓛ | Full inspiration; or slow, deep breathing (3-5* sec)
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| Area of interest for Transthoracic lateral shoulder, Lawrence method, Ⓡ or Ⓛ | shoulder & proximal humerus thru thorax
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| What is the PA oblique, RAO/LAO, of shoulder joint also known as? | Scapular Y
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| IR for PA oblique, RAO/LAO, of shoulder joint | 24 x 30 cm
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| Location of IR for PA oblique, RAO/LAO, of shoulder joint | IR CTR @ SH joint w/ scapula ⊥
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| Patient position for PA oblique, RAO/LAO, of shoulder joint | upright* or recumbent; replace AO w/ PO if pt severly injured; affected shoulder against IR
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| Body rotation for PA oblique, RAO/LAO, of shoulder joint | midcoronal 45-60° to IR
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| CR for PA oblique, RAO/LAO, of shoulder joint | ⊥ to SH joint
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| Respiration for PA oblique, RAO/LAO, of shoulder joint | Suspend
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| Area of interest for PA oblique, RAO/LAO, of shoulder joint | Scapular Y
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| IR for AP Scapula | 24 x 30 cm ↕
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| Location of IR for AP Scapula | Top of IR 2" (5 cm) above shoulder
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| Patient position for AP Scapula | upright* or supine; abduct arm to ⊾ w/ body ∴ draw scapula lateral
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| CR for AP Scapula | ⊥ & 2" (5 cm) ↓ to coracoid process
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| Respiration for AP Scapula | Slow breathing
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| Area of interest for AP Scapula | horizontal scapula thru lung & ribs; acromion process
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| IR for Lateral Scapula, RAO & LAO | 24 x 30 cm ↕
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| Location of IR for Lateral Scapula, RAO & LAO | scapular body ⟂ to IR
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| Patient position for Lateral Scapula, RAO & LAO | prone, supine, upright* (seated or standing); 45-60° RAO or LAO. For acromion or coracoid processes, pt has back of hand on posterior thorax or grasping opposite shoulder; for scapular body, pt extends arm up & over head or across chest
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| CR for Lateral Scapula, RAO & LAO | ⟂ to midmedial border of protruding scapula
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| Respiration for Lateral Scapula, RAO & LAO | Suspend
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| Area of interest for Lateral Scapula, RAO & LAO | lateral scapula w/ position of arm determining portion of superior scapula superimposed over humerus
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| IR for AP Clavicle | 24 x 30 cm ↔
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| Location of IR for AP Clavicle | IR CTR to clavicle
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| Patient position for AP Clavicle | upright* or supine
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| CR for AP Clavicle | ⊥ to midshaft of clavicle
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| Respiration for AP Clavicle | Suspend @ expiration ∴ ↑ uniform density
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| Area of interest for AP Clavicle | entire clavicle w/ uniform density
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| IR for AP/PA axial & AP axial Lordotic Clavicle | 24 x 30 cm ↔
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| Location of IR for AP/PA axial & AP axial Lordotic Clavicle | IR CTR to (center of) clavicle
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| Position of patient for AP axial Clavicle | supine
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| Position of patient for AP axial Lordotic Clavicle | upright
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| CR for AP axial Clavicle | 15-30° cephalad
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| CR for AP axial Lordotic Clavicle | 0-15° cephalad
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| True or false? Hypersthenic pts need ↑ cephalic CR ∠ for AP axial & AP axial Lordotic Clavicle radiographs. | False. Thinner pts req ↑ ∠ to project clavicle off scapula & ribs.
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| Respiration for PA/AP axial & AP axial Lordotic Clavicle | Suspend @ full inspiration ∴ further ↑ & ∠ clavicle
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| Area of interest for PA/AP axial & AP axial Lordotic Clavicle | axial clavicle ↑ ribs
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| Position of patient for PA axial Clavicle | prone or standing
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| CR for PA axial Clavicle | 15-30° caudad
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| What is the bilateral AP projection of AC joints also known as? | Pearson method
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| IR for bilateral AP AC joints, Pearson method | 18 x 43 cm, or 2- 8 x 10" (18 x 24 cm), as needed to fit patient
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| SID for bilateral AP AC joints, Pearson method | 72" (183 cm); ↓ magnif & distortion ∴ both joints on 1 image
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| Location of IR for bilateral AP AC joints, Pearson method | IR CTR @ midline of body along level of AC joints
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| Patient position for bilateral AP AC joints, Pearson method | upright, seated or standing (recumbent not succ); pt holds = wts
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| CR for bilateral AP AC joints, Pearson method | ⊥ to midline @ level of AC joints for 1 proj; ⊥ to unilat AC joint for 2 exp (broad shldr pts)
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| Respiration for bilateral AP AC joints, Pearson method | Suspend
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| Area of interest for bilateral AP AC joints, Pearson method | Bilat AC joints: disloc, separ & funct
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| True or false? A thyroid shield can be used for bilateral AP AC joints, Pearson method. | True
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