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Radiographic Positioning


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Name of projection Scapula - AP
Area Covered Scapula free from superimposition
Pathology shown Fractures of the scapula are demonstrated, shoulder dislocation
Radiographic Anatomy
IR Size & Orientation 24 X 30 cm
Landscape
Film / Screen Combination Regular
(CR and DR as recommended by manufacturer)
Bucky / Grid Moving or stationary grid
Filter No
Exposure 65 kVp
15 mAs
FFD / SID 100cm
Central Ray CR perpendicular to mid scapula, 5 cm inferior to coracoid process, or to the level of axilla, and approximately 5 cm medial from lateral border of patient.
Collimation Collimate on four sides to area of scapula.
Markers Place marker in the upper right / left corner of the exposed field
Shielding Gonadal (check your department's policy guidelines)
Respiration Breathing technique is preferred if patient can cooperate. Ask patient to breathe gently without moving affected shoulder or arm.
Positioning
  • Take radiograph with the patient in an erect or supine position. (The erect position may be more comfortable for patient.) Posterior surface of shoulder is in direct contact with table-top or IR without rotation of thorax.
  • Position patient so that midscapula area is centered to CR.
  • Adjust cassette to center to CR. Top of IR should be about 2 inches , or 5 cm, above shoulder, and lateral of IR should be about 2 inches (5 cm) from lateral margin of rib cage.
  • Gently abduct arm 90 degrees and supinate hand.
Critique

 Positioning
  • Affected arm seen to be abducted 90 degrees and hand supinated, as evidenced by the lateral border of the scapula free of superimposition.
Area Covered
  • Area of the affected scapula
Collimation
  • Collimation should be visible on four sides to the area of the affected scapula. CR and center of the collimation field should be at midscapula area.
Exposure
  • Optimal density and contrast with no motion will demonstrate clear, sharp bony trabecular markings of the lateral portion of the scapula. Ribs and lung structures will appear blurred with proper breathing technique.
Special Notes Reference: Textbook of Radiographic Positioning and Related Anatomy, Sixth Edition, by Kenneth L.Bontrager and John P. Lampignano.



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