Shoulder Flashcards
(49 cards)
shoulder plain film views (11)
- anteroposterior (AP) ER
- anteroposterior IR
- Grashey (posterior oblique)
- axillary (superoinferior)
- Westpoint
- Lawrence
- transthoracic lateral view
- bicipital view
- acromioclavicular view
- transcapular (Y) view
- outlet
structures seen within AP view (4)
- proximal 1/3 of humerus
- lateral 2/3 of clavicle
- AC joint
- superior + lateral portions of scapula
AP view limitation
medial portion of humeral head overlaps glenoid fossa (posterior) and obscures GH joint space
AP view position and beam
- pt supine/erect
- arm fully extended in neutral positions
- central beam through humeral head
- IR/ER to visualize different aspects of humeral head
AP view with ER = _________ at most lateral aspect of humeral head and _______ superimposed over middle area of humeral head
greater tuberosity; lesser tuberosity
AP view with IR = __________ at most medial aspect of humeral head and ______ superimposed over middle area of humeral head
lesser tuberosity; greater tuberosity
permits glenoid to be seen in profile
Grashey view
Grashey view position and beam
- pt supine/erect
- whole body rotated 40 degrees toward side of injury
- central beam through GH joint
- makes glenoid space clearly visible
pathologies commonly confirmed in Grashey view
- posterior shoulder dislocation
- Os acromiale
obliteration of normally clear space between humeral head and glenoid margin in Grashey view (pathology)
posterior shoulder dislocation
developmental variant of anterior portion of the acromion; represents unfused accessory center of ossification of the acromion
os acromiale (not a fracture!); inc risk for subacromial impingement d/t dec shoulder mobility
best for determining exact relationship between humeral head and the glenoid
axillary view (superoinferior)
axillary view position and beam
- arm ABD
- radiographic tube angled 5-10 degrees toward elbow
- beam through superior-inferior or inferior-superior shoulder
pathologies often confirmed c/ axillary view
- disolocation (ant or post)
- os acromiale
- good for pre/post reduction check
axillary view disadvantage
- difficult to obtain if pt cannot ABD arm
* use Westpoint instead
common structures seen in axillary view:
- lesser tuberosity
- coracoid process
- distal end of clavicle
- anterior glenoid rim
- acromion
- scapula
pale white nodules in area of biceps tendon or spur off distal acromion
calcifications and osteophyte formations (AC joint area views)
abnormal relationship of humeral head to glenoid fossa
dislocation (all views)
relationship of humeral head and glenoid can be seen (axillary view) AND anteroinferior glenoid rim better visualized
Westpoint view (deviation from axillary)
Westpoint view position and beam
- prone c/ pillow under shoulder to raise it ~8 cm
- beam angled toward axilla at 25 degrees to pt’s midline and 25 degrees to table surface
shows same structures as axillary view but does not require full ABD
Lawrence view
*ABD compensated by radiographic tube/beam angle
Lawrence view position and beam
- supine
- arm ABD up to 90 degrees
- beam starts at level of ipsilateral hip
- beam angulation dependent upon degree of ABD
- less ABD = inc medial angulation
true lateral view of proximal humerus; valuable to determine degree of displacement/angulation of bony fragments of proximal humerus
transthoracic lateral view
transthoracic lateral view position and beam
- erect c/ injured arm against table
- ABD opposite arm so forearm rests on head
- beam directed below axilla, slightly above nipple line
