ShoulderGH jt
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Transcript ShoulderGH jt
Shoulder
Glenohumeral Joint
AP shoulder girdle
Three projections with different positions of
the arm will demonstrate the humeral head
& neck in different views.
AP with arm in external rotation – True AP
AP with arm in neutral position
AP with arm in internal rotation –humerus
in lateral
External rotation
Greater tubercle
(arrow)
Neutral rotation
Internal rotation
Lesser tubercle
(arrowhead)
AP with arm in external rotation –
True AP
Patient & part position
Supine or erect
Rotate patient slightly to place the spine of
the scapula approximately parallel with the
plane of the cassette
Abduct the arm slightly and the palm
forward to bring the coronal plane of the
epicondyles parallel to the cassette
AP with arm in neutral position
Patient & part position
Supine or erect
Rotate patient slightly to place the spine of
the scapula approximately parallel with the
plane of the cassette
Rest the palm of the hand against the thigh
to bring the humerus in neutral position
Direct Central ray perpendicular to the
cassette over coracoid process.
AP with arm in internal rotation –
humerus in lateral
Patient & part position
Supine or erect
Rotate patient slightly to place the spine of the
scapula approximately parallel with the plane of
the cassette
Flex the elbow somewhat and rotate the arm
internally and rest the back of the hand on hips
to bring the humerus in lateral position
Direct Central ray perpendicular to the cassette
over coracoid process.
AP oblique for glenohumeral joint
AP oblique for glenohumeral joint
Patient & part position
Supine or erect
Rotate patient about 350 to place the body
of the scapula parallel with the plane of the
cassette
Abduct the arm slightly in internal rotation
Direct Central ray perpendicular to a point
5 cm medial and 5 cm below superolateral
border of the shoulder (over coracoid
process).
Shoulder Axial
Supero-inferior
Infero-superior
Shoulder Axial Superoinferior
Direct the central ray through the shoulder joint
with the tube angled 5 -10 degrees towards the
elbow
Shoulder Axial Superoinferior
Patient
seated on a chair close to the edge
of the table
Raise the arm as close as possible right
angles to the body
Lean the patient laterally to bring the axilla
over the cassette while elbow rests on the
table
Elbow flexed at 900 and hand pronated
Turn the head towards unaffected side
Inferosuperior
PA oblique (scapula Y)
Useful in the evaluation of suspected shoulder
dislocations
Supraspinatus “Outlet”
To
demonstrate tangentially the
coracoacromial arch or outlet to diagnose
shoulder impingement
The tangential image is obtained by
projecting the x-ray beam under the
acromion and AC joint, which defines the
superior border of the coracoacromial
outlet.
Outlet view – for shoulder impingement
RAO/LAO(Modified scapula Y projection)
Patient
upright and lateral with affected
shoulder to center of the bucky
Rotate patient forward to make body of
scapula perpendicular to cassette
Elbow flexed and forearm across the
anterior (or posterior for body of scapula)
chest
Direct central ray angled 100 down from
horizontal through head of humerus
Outlet view – for shoulder impingement
(modified scapula Y)
AP axial (Stryker ‘notch’ view)
To
demonstrate ‘Hill-Sachs defect’
Anterior dislocations of the shoulder
frequently result in posterior defects
involving the posterolateral head of the
humerus, called Hill-Sachs defects.
AP axial (Stryker ‘notch’ view)
Transthoracic lateral
To
demonstrate proximal humerus in a 90
degree projection from the AP projection
when trauma exists and the arm cannot be
rotated or abducted because of an injury