Pre-Film Eval

projection/position

CR

AP projection of Humerus - External Rotation

(epicondyles are parallel + equidistant from IR)

CR midpoint of humerus

projection/position

CR

Lateromedial projection of Humerus - Internal Rotation

CR midpoint of humerus

projection/position

elbow degree

oblique degree

CR

Mediolateral projection of Humerus

elbow 90

patient oblique 20-30 from PA

CR midpoint of humerus

projection/position

CR

elbow degree

why this projection instead of ‘normal’

Trauma Horizontal Beam Lateromedial Mid-to-Distal Humerus

ensure horizontal beam is 90 from AP view

CR to distal 2/3 humerus

elbow flexed 90, shoot this when elbow is unable to extend

projection/position

arm position

CR

if arm can not be raised

Trauma Transthoracic Lateral projection of Humerus

affected arm in neutral position

CR mid-diaphysis of humerus

if unable to reach arm over head, CR 10-15 cephalad angle

projection/position

CR

AP projection of Shoulder - External Rotation

CR 1 inch/2.5 cm inferior to coracoid process

projection/position

CR

AP projection of Shoulder - Internal Rotation

CR 1 inch/2.5 cm inferior to coracoid process

projection/position

CR

Trauma AP projection of Shoulder - Neutral Rotation

CR to midscapulohumeral joint = ¾ inch inferior + slightly lateral to coracoid process

projection/position

patient position

CR

if arm cannot extend, what do you do

Inferosuperior Axiolateral projection of Shoulder - Lawrence Method

shoulder raised 2 inches from table + elbow 90 + arm in external rotation

CR medially 20-30, centered to axilla + humeral head

if arm less 90, CR medial angle is 15-20

projection/position

reasoning for this

shows Hill-Sachs defect

Inferosuperior Axial projection of Shoulder - Lawrence Method w/ exaggerated External Rotation

BUT HAS ALTERNATIVE POSITION = exaggerated external rotation

projection/position

elbow degree

hand position

CR

Superoinferior Transaxillary projection of Shoulder

elbow 90 + pronate hand

CR to glenoid fossa = 5-15 toward elbow

projection/position

oblique degree

arm position

IR

CR

AP Oblique projection of Glenoid Cavity of Shoulder - Grashey Method

body 35-40 oblique + arm in neutral position

IR 2 inches above shoulder + 2 inches from lateral side of humerus

CR to scapulohumeral joint = 2 inches inferior + 2 inches medial from superolateral border of shoulder

projection/position

CR

Trauma Transthoracic Lateral projection of Proximal Humerus

CR to surgical neck

projection/position

position oblique

CR

Trauma PA Oblique Projection of Scapular Y Lateral of Shoulder

anterior oblique until imaginary line of superior angle of scapula + AC joint articulation perpendicular to IR = range of 45-60

CR to scapulohumeral joint = 2 inches/5cm below AC joint

which image is the dislocation

left

humerus should be in middle of scapy-y

projection/position

patient position

CR

reason for projection

Trauma Tangential projection of Supraspinatus Outlet of Shoulder - Neer Method

anterior oblique until imaginary line of superior angle of scapula + AC joint articulation perpendicular to IR

CR 10-15 caudal

CR 1 inch superior to medial aspect of scapular spine

use this projection to see impingement syndrome

projection/position

CR

if opposite projection, what is CR

[top] AP projection of Clavicle

CR to midclavicle

[bottom] AP Axial projection of Clavicle

CR to midclavicle + 15-30 cephalad angle

if PA axial projection of clavicle, CR is caudal 15-30

projection/position

CR

IR

AP projection of AC joints

top of IR 2 inches above shoulder

CR midpoint of AC joints = 1 inch above jugular notch

for unilateral center CR 1 inch below AC joint

projection/position

IR

arm degree

hand position

CR

AP projection of Scapula

top of IR 2 inches above shoulder + side of IR 2 inches from lateral margin of rib cage

arm 90 + supinate hand on forearm

CR to midscapula = 2 inches inferior to coracoid process + 2 inches medial from lateral border of patient

projection/position

reason for this

rotation degree

CR

Lateral Position of Scapula

shows body of scapula so arm is placed in front w hand on opposite shoulder

typical rotation 45 LAO

CR to midvertebral border of scapula

projection/position

reason for this

degree rotation

CR

Lateral Position of Scapula

shows Acromion + Coracoid Process so arm is behind back at an angle

typical 60 LAO

CR to midvertebral border of scapula

projection/position

CR

Lateral Position of Scapula - Patient Recumbent

just to see body of scapula

CR midscapula lateral border