Babeh Edi

Shoulder Humerus AP

Indications for imaging Trauma - dislocations, fractures, soft tissue calcifications Arthritis survey Bone pain. Anatomy  Demonstrated Humerus Anatomy AP Rt (from) Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London   Basic Patient Position The patient stands erect AP, the position of the film is adjusted to included the shoulder and elbow joints. The patients arm is abducted approximately 20 degrees and externally rotated to bring  the distal epicondyles equidistant from the film, the patient may need to be rotated to the affected side. The humerus may need to be positioned diagonally across the film to included the full length. Humerus Anatomy AP Lt Patient Position Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Radiation protection Direct lead rubber gonad protection using a "half apron". Avoid irradiating the thyroid and breast tissue as much as possible.   Central Ray The horizontal central ray is centered midway between the skin surfaces at the midpoint of the humerus. Exposure is made on suspended expiration. Exposure Factors Kv mAS FFD (cm) Grid Focus AEC Cassette 80 6 100 No Fine No 24x30 cm   Evaluation of the Image ID and markers must be present and correct in the appropriate area of the film. Limits of the examination, superiorly the shoulder inferiorly the proximal 3cm of the forearm, medially the gleno humeral joint and laterally the skin surfaces. Evidence of collimation on four sides equally around the centering point The humeral head should be minimally superimposed on the glenoid and the greater  tuberosity should be in profile. Distally the elbow joint should be projected in a true AP position, with he distal epicondyles in profile. The exposure should demonstrate all the soft tissues and penetrate the denser proximal portion without over exposure of the less dense distal portion, utilisation of the anode heal effect, anode side of the tube inferiorly may help to reduce the exposure to the distal portion. Normal Humerus AP Lt (from) http://www.vh.org Related Projections Humerus Lat Shoulder joint AP Supero-inferior Elbow AP Elbow Lat Additional modalities RNI evaluation of metastases