Clavicle - AP shoulderThis is a featured page

Radiographic Positioning


Adult
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Name of projection Clavicle - AP
Area Covered Entire clavicle, acromioclavicular joint, sternoclavicular joint
Pathology shown Fractures and dislocations
Radiographic Anatomy Shoulder Radiographic Anatomy
IR Size & Orientation 24cm x 30 cm
Landscape
Film / Screen Combination Regular
(CR and DR as recommended by manufacturer)
Bucky / Grid Moving or stationary grid, no grid for children
Filter Using the shoulder filter is optional
Exposure 65 kVp
16 mAs
FFD / SID 100cm
Central Ray Directed to mid-clavicle
Perpendicular to IR
Collimation Centre: Palpate both ends of the clavicle and direct the central ray half-way between
Shutter A: Include the jugular notch to beyond the acromio-clavicular joint
Shutter B: To include the entire clavicle
Markers Lateral/Superior
Marker orientation is AP
Shielding Gonadal (check your department's policy guidelines)
Respiration Not applicable
Inspiration may aide in elevating the clavicle
Positioning
  • Patient stands erect with back to upright bucky (can do supine)
  • Make sure they are standing up straight and not slouching
  • Arms at sides
  • Chin raised
  • Eyes looking straight ahead
  • Posterior aspect of shoulder to the upright bucky
  • Ensure both shoulders are equal in distance from the upright bucky
  • Centre the light field to the clavicle
  • Centre the IR
Critique

 Positioning
No rotation of patients shoulders is evidenced by:
  • The clavicle exhibits no longitudinal foreshortening
  • The sternal end of the clavicle lies next to the vertebral column
Patient's torso is upright (upper mid-coronal plane is vertical), is evidenced by:
  • The clavicle exhibits no inferosuperior foreshortening
  • The middle of the clavicle is super-imposed on the superior scapula angle
Area Covered
  • Entire clavicle, acromioclavicular joint, sternoclavicular joint
Collimation
  • Centre: Palpate both ends of the clavicle and direct the central ray half-way between
    Shutter A: Include the jugular notch to beyond the acromio-clavicular joint
    Shutter B: To include the entire clavicle
Exposure
  • Bony trabeculation and cortical outlines of the clavicle are sharply defined
  • Soft tissues are visualised
Special Notes Note: This projection can also be done PA if neccessary for patient comfort. It also puts the clavicle closer to the IR

Determing direction of rotation of patients shoulders
  • If the sternal end of the clavicle is positioned over the vertebral column, the affected side is further away from the IR

Determining direction of tilt of patients upper mid-coronal plane (that is the patient is tilting forward or backward)
  • The middle of the clavicle should be super-imposed over the superior angle of the scapula
  • If the superior angle of the scapula is projected superiorly to the mid-clavicle the patient is leaning forward



AndyC
AndyC 		Latest page update: made by AndyC , May 29 2011, 8:07 AM EDT (about this update About This Update AndyC Edited by AndyC

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Keyword tags: acromio-clavicular joint clavicle long bone shoulder sternoclavicular joint
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