3b. Shoulder & Spine Views and Positioning

Question 1

what is the patient position for an supero-inferior axial shoulder

in terms of IR height, affected arm and head

Answer 1

seated with side affected next to IR

raise IR to mid thoracic height

affected arm abducted with elbow resting on table

head tilted away

Question 2

what is the CR and CP of the supero-inferior axial shoulder

Answer 2

5-10* CR angle towards elbow

CP = glenohumeral joint

Question 3

what is the position critique for the axial supero-inferior view of the shoulder

Answer 3

coracoid sitting up and acromion below HOH

Question 4

what is the area critique for the axial supero-inferior view of the shoulder

Answer 4

humeral head and glenoid included

Question 5

what is the patient position for an impingement view

Answer 5

PA

rotated unaffected side to bring line between medial scap border and AC joint perp to IR

Question 6

what is the clinical indications for an impingement view

Answer 6

rotator cuff damage

impingement

Question 7

what is the CR and CP of the impingement view

Answer 7

15-20* caudal angulation

2cm superior to the medial end of the scapula spine

Question 8

what is the positioning critique for an impingement view

4 things

Answer 8

scapula in Y appearance

visualise supraspinatus outlet

acromion coracoid for Y arms and Humeral head superimposed at y base

Question 9

what is the patient position for an anterior oblique SC joint

Answer 9

raise each side 10-15*

prone position

Question 10

what is the clinical indications for an anterior oblique SC joint

Answer 10

joint separation/subluxation

dislocation/trauma/infection or deformity in absence of trauma

Question 11

what is the CR and CP of the anterior oblique SC joint

Answer 11

center to raised side lateral to spine at T2/3 level

Question 12

what is the positioning critique for the anterior oblique SC joint

Answer 12

want to see distance between manubrium and clavicle

Question 13

what is the clinical indications for an serendipity view

Answer 13

suspected dislocation

Question 14

what is the patient position for an serendipity view

Answer 14

supine

Question 15

what is the CR and CP of the serendipity view

Answer 15

level of SC joints

angle 40* cranial

Question 16

what is the positioning critique for the serendipity view

in terms of what shows good angle and what the clavicle should be like

Answer 16

good angle = bony structure seen without excessive distortion

medial ends of clavicle equidistant apart in same horizontal plane

Question 17

what is the collimation for the serendipity view

Answer 17

medial ends of both clavicles laterally

inferior to include SC joint and part of manubrium

Question 18

what is the area of interest for the serendipity view

Answer 18

entire SC joint

Question 19

what is the clinical indications for an flexion/extension Lumbar view

Answer 19

spinal instability
spondylolisthesis
degree of motion of lumbar spine

Question 20

what is the CR and CP of the flexion/extension Lumbar view

Answer 20

iliac crest/lower costals - same as lateral lumbar spine

Question 21

what is the patient position for the flexion/extension Lumbar view

Answer 21

flexion = hips, shoulders, thighs drawn close together while flexing forwards

extension = arch back

Question 22

what is the positioning critique for the flexion/extension Lumbar view

what shows that the spine is parallel to the IR and what shows no rotation

Answer 22

spinal column parallel to IR = open intervertebral foramina and joint spaces

no rotation = GSN superimposed and posterior vert bodies superimposed

Question 23

what is the area of interest for the flexion/extension Lumbar view

Answer 23

T & L spine

some of iliac crests