Scapula and Clavicle pathology and anatomy

what is clavicle A

SC joint

what is clavicle B

sternal end

what is clavicle C

shaft/body

what is clavicle D

acromion

what is clavicle E

AC joint

posterior scapula A

supraspinous fossa

posterior scapula B

infraspinous fossa

posterior scapula C

lateral border

posterior scapula D

lateral angle

posterior scapula E

neck

posterior scapula F

glenoid cavity

posterior scapula G

acromion

posterior scapula H

coracoid process

posterior scapula I

scapular notch

posterior scapula J

superior border

posterior scapula K

superior angle

posterior scapula L

crest of spine

posterior scapula M

medial border

posterior scapula N

inferior angle

anterior scapula A

acromion

anterior scapula B

neck

anterior scapula C

glenoid cavity

anterior scapula D

lateral border

anterior scapula E

body

anterior scapula F

subscapular fossa

anterior scapula G

medial border

anterior scapula H

superior angle

anterior scapula I

superior border

anterior scapula J

scapular notch

anterior scapula K

coracoid process

the clavicle on a female is

shorter, less curved

the clavicle on a male is

thicker, more curved

what type of bone is the clavicle

long bone (has two articular ends)

pectoral girdle A

AC joint

pectoral girdle B

acromion?

pectoral girdle C

scapula

pectoral girdle D

manubrium/sternum

pectoral girdle E

SC joint

pectoral girdle F

sternal end

pectoral girdle G

clavicle body/shaft

pectoral girdle H

acromial end

 what is letter A? (joint)

sternoclavicular joint

what is letter B? (joint)

sternoclavicular ligament

what is letter A (joint image)

AC ligament

what is letter B (joint image)

acromion

what is letter C (joint image)

clavicle

what is letter D? (joint image)

CC ligaments

acromioclavicular dislocation definition

clavicle separates from the scapula (acromion)

acromioclavicular dislocation cause

traumatic

radiographic appearance of acromioclavicular dislocation

widening of AC joint

technical change for acromioclavicular dislocation

no manual exposure factor change

impingement syndrome definition

impingement of the greater tuberosity and soft tissues on the coracoacromial ligamentous and osseous arch, generally during abduction (Bontrager)

impingement syndrome cause

trauma, idiopathic

radiographic appearance of impingement syndrome

the presence of bony excrescences arising from the anteroinferior aspect of the acromion and of flattening and sclerosis of the greater tuberosity of the humerus (RSNA) or os acromiale

technical change for impingement syndrome

no manual exposure factor change

what is this an x-ray of?

acromioclavicular dislocation

Another cause of impingement syndrome

constant rubbing of the acromion and the rotator cuff (from class)

what is this an image of?

impingement syndrome

os acromiale

developmental aberration in which the distal acromion fails to fuse, can lead to impingement

AP Clavicle image critique

• lateral half of clavicle above the scapula, with the medial half superimposing the thorax

• entire clavicle centered on image

respiration for AP clavicle

suspended respiration

Merrill’s recommendations for AP clavicle

12 × 8 collimation

AP axial clavicle image critique

• entire clavicle along with AC and SC joints

• lateral 2/3rds of the clavicle projected above the ribs and scapula with the medial end superimposing the thorax

• clavicle in horizontal orientation as compared with the AP projection

Merrill’s recommendations for AP axial Clavicle

• 0-15 degree for standing lordotic position

• 15-30 degrees for supine position

AP scapula image critique

• lateral position of the scapular free of super imposition from the ribs

• scapular horizontal and not slanted

• scapular detail through the superimposed lung and ribs (shallow breathing should help obliterate lung detail)

• acromion and inferior angle

lateral scapular (posterior oblique, AP projection)

• lateral and medial scapular borders superimposed

• no superimposition of the scapular body on the ribs

• no superimposition of the humerus on the area of interest

• inclusion of the acromion and inferior angle

Another way to do lateral scapula

can also be obtained as an Anterior Oblique (LAO or RAO) with affected side against the board

scapula is considered a

flat bone

anterior side of the scapula is called

costal side

posterior side of the scapula is called

dorsal side

the inferior border of the scapula is around the same location as the

7th rib

AC joints (AP Neutral/ AP neutral weightbearing image critique

• AC joint visualized

• L or R marker and weight bearing marker

• AC joint separation, if present

Merrill’s note for AC joints

• collimation 6×8

• 72” SID

• recommends bilateral on one image

SC joints PA image critique

• both SC joints and the medial ends of the clavicles

• no rotation

SC joints PA oblique (RAO/ LAO) image critique

• SC joint of interest in the center of the radiograph, with the manubrium and the medial end of the clavicles included

• open SC joint space

• SC joint of interest immediately adjacent to the vertebral column with minimal obliquity