shoulder girdle

acromioclavicular joint (AC joint)

sternoclavicular joint (SV joint)

lateral border of scapula

green

greater tuberosity

red

lesser tuberosity

purple

humeral head

pink

anatomical neck

acromion of scapula

acromial extremity of clavicle

sternal extremity of clavicle

superior border of scapula

lateral border of scapula

medial border of scapula

scapulohumeral joint

what is shoulder dislocation

landing on outstretched arm

what are the different types of shoulder dislocation

complete, partial, anterior, posterior

what is patient position for ap shoulder girdle

erect with back against the erect bucky, slight rotation to the side of interest so the side of interest is in contact with the bucky

what is the anatomy for ap shoulder

clavical to sc joint, scapula to inferior border, proximal 1/3 humerus, lateral and superior soft tissue margins

what is relative position for ap shoulder

correct rotation is evidenced by both greater and lesser tubercles superimposed by head, scapula parallel to IR

what is the aesthetics for ap shoulder

full superior quadrant of the shoulder girdle with centre point to the ROI

do you need to use grid for ap shoulder

yes

what is the part position for lateral shoulder

fix elbow to 90° and place hand across the front of the body, epicodyles should be superimposed, abduct the arm so that the humeral shaft is separate from the body, align the acj and the medial border of the scapula to be perpendicular to the detector

what is the centre point for lateral shoulder

scapulohumeral joint (5-6cm) below the top of shoulder

do you need grid for lateral shoulder

yes

what is the collimation for lateral shoulder

full length of scapula, acromion and coracoid process = Y

what is anatomy for lateral shoulder

lateral and superior soft tissue margins, all of scapula, lateral soft tissue margins

what is the relative position for lateral shoulder

body of scapula should be end on without superimposition over ribs, acromion and coracoid process Y ( humeral head in the sub acromial space)

what is garth’s positioning used for

only for suspected dislocation

what is the patient position for Garth’s shoulder

erect (stand or sit), ap with soi posterior oblique 45°

what is the centre point for garth’s shoulder

glenohumeral joint

what is the central ray for garth’s shoulder

45° caudal

what is the anatomy for Garths shoulder

humeral head, glenoid cavity, neck and head of scapula free of superimposition

what is the relative position for garth’s shoulder

correct rotation is evidenced by coracoid process is projected over part of elongated humeral head, acromion and ac joint are superior to humeral head

what is the aesthetics for garths shoulder

full superior quadrant of the shoulder girdle with centre point to the roi

anterior dislocation

posterior dislocation

teres minor

coracoacromial ligament

what is the rotator cuff composed of ( IMPORTANT)

tendons of the subscapularis, supraspinatus, infraspinatus and teres minor

what is impingement syndrome

where the bones in your shoulder rub or pinch your rotator cuff tendons and bursa

what are signs of impingement in xray

narrowed subacromial space, abnormal shape of the aromion or osteoarthrosis

what are the calcification of rotator cuff

calcium deposits in the rotator cuff

what is frozen shoulder

Frozen shoulder is a progressive disorder of the glenohumeral joint where the joint capsule contracts, thickens, and forms adhesions, severely restricting both active and passive range of motion

what is the patient position for ap grashey shoulder

patient erect with back against the erect bucky, rotate to the side of interest (30-45) so the SOI is in contact with the bucky

where is the centre point for grashey shoulder

on the GHJ - 2.5cm inferior to coroacoid process ( 2cm inf to lateral clavicle)

do you need to use grid for grashey shoulder

yes

what is the collimation for grasheys shoulder

increase collimation, centred over the joint- no need to include the full scapula or clavicle, include superior and lateral skin margins

what is the relative position of grasheys shoulder

correct rotation is evidenced by glenohumeral joint should be open, anterior and posterior rims of glenoid should be superimposed

what is the part position for ap internal rotation 5° caud shoulder

slightly abduct and internally rotate the arm so the hand is pronated (epicondyles of humerus are perpendicular to IR)

do you need grid for ap internal rotation 5 caud shoulder

yes

what is the centre ray for ap internal rotation 5°caud shoulder

5° caudal ( towards the feet)

what is the relative position for ap internal rotation 5 caud shoulder

correct rotation is evidenced by lesser tubercle in profile on medial side, open subacromial space (due to caudal angle)

what is part position for ap external rotation 5° caud shoulder

slightly abduct and externally rotate the arm so the hand is pronated (epicondyles of humerus are parallel to IR)

what is the relative position for ap external rotation 5° caud

correct rotation is evidenced by external rotation greater tubercle in profile laterally, angle of the tube opens up the sub acromial space

what is patient position for neer’s shoulder

erect, pa with soi closest to the IR

what is part position for neer’s shoulder

arm slightly abducted, hand across abdomen, superimpose the superior angle of scapula and the ACJ

what is the centre point for neer’s shoulder

sub-acromial space

what is the central ray for neer’s shoulder

10-15 caudal

what is the relative position for neer’s shoulder

body of scapula should be end on without superimposition over ribs, acromion and coracoid process Y, supraspinatus outlet open

what is the aesthetics for neer’s shoulder

humeral head superior, in centre of IR, flip image so looking front on

what is the patient position for axial shoulder

patient sitting at the end of the table with SOI closest

what is part position for axial shoulder

abduct arm so shoulder over IR

what is the central ray for axial shoulder

0-15° down humerus depending on flexibility of patient

do you need grid for neers shoulder

yes

do you need grid for axial shoulder

no

what is the anatomy for axial shoulder

coracoid process and lesser tubercle seen in profile

what is the relative position for axial shoulder

correct position is evidenced by anterior and posterior rims of glenoid cavity are superimposed

fracture clavicle

ACJ separation (dislocation)

fracture scapula

what is breathing technique (ap scapula)

shallow breathing to blur the ribs

what is the position of ap scapula

erect with back against erect bucky, slight rotation to the side of interst so the scapula is parallel with the IR, abduction of the arm and supination of the hand to isolate the lateral border of the scapula free from superimposition on the ribs (pt rest hand on head)

what is position for lateral scapula

stand facing the erect bucky/oblique as needed (30°) with the anterior of the side of interest closest to the detector, fix elbow to 90° and place hand across the front of the body, epicondyles should be superimposed, adduct the arm so the humeral shaft is anterior to the body, bring tightly across the front of the patient’s body

what is the collimation for ap and lateral scapula

entire scapula, full length of scapula, acromion and coracoid process =Y

do you need grid for ap and lateral scapula

yes

what is the relative position for ap scapula

lateral portion of scapula free of superimposition of ribs

what is the relative position for lateral scapula

correct rotation is evidenced by humerus should not superimpose the scapula too much, body of scapula should be end on without superimpositionoer ribs, acromion and coracoid process Y

what is the patient position for ap clavicle and axial clavicle (colimated, follow up)

patient erect with back against the erect bucky, slight rotation AWAY from the side of interest so the clavicle is parallel with the IR

what is the central ray for axial clavicle ( collimated)

angled 15-30 ° towards the head

what is the anatomy to include for follow up clavicle

clavicle, acromion to sternum, lateral and superior soft tissue margins

what is the relative position for ap clavicle follow up

correct rotation is evidenc

ed by clavicle parallel to IR and not foreshortened

what is the relative position for axial clavicle

correct rotation is evidenced by clavicle parallel to IR (not foreshortened), clavicle projected superior t

o most of the scapula and the 2nd, 3nd ribs

what is patient position for ap bilateral acj

ap erect, no rotation of the body (ned each side to be equal)

what is the centre point of ap bilateral acj ( one exposure)

absolute mid-line 2.5cm above jugular notch

what is the centre point for ap bilateral acj (singular acj)

directly over the acj

what is the sid for ap bilateral acj

180cm

do you need grid for ap bilaeral acj

yes

what is position for weight bearing ap bilateral acj

what is the relative position for ap bilateral acj

correct rotation is evidenced by symmetric appearance of the SC joint