| Name of projection | Shoulder - Anterioposterior (AP) |
| Area Covered | Glenohumeral joint, acromioclavicular joint, sternoclavicular joint, coracoid process, clavicle, superior scapula, proximal third of humerus |
| Pathology shown | Fractures, dislocations, calcium deposits in muscle, tendon and bursae |
| Radiographic Anatomy | Shoulder Radiographic Anatomy |
| IR Size & Orientation | 24cm x 30cm
Landscape |
| Film / Screen Combination | Regular
(CR and DR as recommended by manufacturer) |
| Bucky / Grid | Moving or stationary grid
Can be done either in bucky or out of bucky with exposue modified accordingly |
| Filter | Shoulder filter |
| Exposure | 65 kVp
16 mAs (in Bucky)Bucky expopsure) |
| FFD / SID | 100cm |
| Central Ray | Directed to the glenohumeral joint
Perpendicular to the IR |
| Collimation | Centre: Glenohumeral joint, this is 2.5cm below the palpatable coracoid process
Shutter A: Open to include the top of the shoulder and approximately one third of the proximal humerus
Shutter B: Open to include just beyond the humeral skin line and the sternoclavicular joint |
| Markers | Lateral and superior
Marker orientation is AP |
| Shielding | Gonadal (check your department's policy guidelines) |
| Respiration | Suspended |
| Positioning | - Patient standing with back to upright bucky (can dobe performed supine)
- Check the patient is standing up straight (their upper mid-coronal plane is vertical and parallel to IR)
- Rotate the patient slightly, if necessary, so that their affected shoulder is in contact with the upright bucky
Arm rotation
- Note: A shoulder series normally includes anAn AP projection (this page) plus other projections, one of which is the glenohumeral (GH) projection. Oneshoulder shouldcan be doneperformed with internal rotation andeither theinternal otheror withexternal external.rotation. This shows both the tubercles.
- Check your department's policy as to which, internal or external, is preferred
- If a fracture is suspected DO NOT rotate the arm, leave in the neutral position
Internal rotation of the arm
- Internally rotate arm
- Place back of hand against thigh
- This will show the lesser tubercle in profile
External rotation of the arm
- Externally rotate arm
- Do this by supinating the hand until the epicondyles of the distal humerus are parallel to the IR
- This will show the greater tubercle of the humerus in profile
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Critique
| Positioning
- The entire clavicle
- Medial end of clavicle is seen next to the lateral vertebral column
- The humeral head should overlap the glenohumeral joint (this occurs more with internal rotation compared to external or neutral position of the humerus)
- No foreshortening of the scapular body
- Humerus parallel with body
Internal arm rotation
- Lesser tubercle in profile medially
- Greater tubercle super-imposed on humeral head
External arm rotation
- Greater tubercle in profile laterally
- Lesser tubercle super-imposed on humeral head
Area Covered
- Glenohumeral joint, acromioclavicular joint, sternoclavicular joint, coracoid process, clavicle, superior scapula, proximal third of humerus
Collimation
- Centre: Glenohumeral joint
- Shutter A: Open to include the top of the shoulder and approximately one third of the proximal humerus
- Shutter B: Open to include just beyond the humeral skin line and the sternoclavicular joint
Exposure
- Bony trabecular patterns and cortical outlines are sharply defined
- Soft tissues are visualised
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| Special Notes |
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