Babeh Edi

Shoulder Infro - superior Supine

Indications for imaging Trauma - dislocations, fractures,  Anatomy  Demonstrated Gleno humeral joint, lateral of proximal humerus, acromium and corocoid without superimposition Shoulder Anatomy Lt Axillary Anatomy Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Basic Patient Position The patient lies supine with the shoulder raised up on a small pad about 2 inches and the head supported, the trunk and legs are angled away from the side to be imaged which is placed safely near the edge of the trolley or couch top. The arm of the affected side is abducted 90 degrees and the elbow flexed to aid external rotation and supported (a drip stand can be a useful aid). An small cassette is placed and supported using a small sandbag above the skin surface of the shoulder well into the root of the neck which is flexed towards the opposite side. Shoulder Rt Axiallry Patient Position Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Radiation protection Avoid irradiating the thyroid and breast tissue as much as possible. Place direct lead rubber gonad protection between the tube head and the patient. Central Ray The horizontal central ray is directed 10-20 degrees medially to the mid axillary region midway between the dorsal and ventral skin surfaces. Exposure is made on suspended expiration. Exposure Factors Kv mAS FFD (cm) Grid Focus AEC Cassette 80 15 150 No Fine No 18x24 cm 85 12 100 Yes Fine Yes 18x24 cm Thickset patients may require the use  of a grid 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 anterior skin surface of the shoulder and anterior chest wall, posteriorly the spine of the scapula, laterally the proximal quarter of the humerus, medially the coracoid process. Evidence of collimation on four sides equally around the centering point The position of the head of the humerus related to the glenoid must be well demonstrated, the acromium spine of scapula and the coracoid process should all be clearly visible.  Normal Shoulder Lt Anatomy Axillary view (from) http://www.vh.org Related Projections Alternative projections producing similar results are the supero-inferior erect and the infero-superior erect, however many trauma patients may have other injuries and the supine method may be the only one possible, Trans-thoracic projections to demonstrate the relationship of the humerus to glenoid should be avoided due to the high dose implications related to the amount of information gained.. Shoulder joint Shoulder joint Survey Modified Axial Scapula lateral Clavicle PA Acromio-clavicular joint AP Additional modalities