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Jun 18 2011, 10:39 AM EDT AndyC 10 words deleted

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Radiographic Positioning


Adult
Other related pages of interest


Name of projectionShoulder - Glenohumeral (GH)

Also called: Glenoid cavity
Area Covered Glenohumeral joint, humeral head, proximal humerus, acromion, acromion space, coracoid process, distal clavicle
Pathology shown Demonstrates the integrity of the glenohumeral joint (dislocations), fractures
Radiographic Anatomy Shoulder Radiographic Anatomy
IR Size & Orientation 18cm x 24cm
Portrait
Film / Screen Combination Regular
(CR and DR as recommended by manufacturer)
Bucky / Grid Upright bucky
Can be done out of bucky, change exposures accordingly
Filter Shoulder filter
Exposure 65 kVp
16 mAs
FFD / SID 100cm
Central Ray CR angled 15° to 22° degrees caudadcaudal (to show acromion space)
Directed to the glenohumeral joint
Collimation Four sides of collimation
ShutterCollimate so that the upper and lateral borders of the A:light field are to the soft tissue margins
Markers Lateral and superior
Marker orientation is AP
Shielding Gonadal (check your department's policy guidelines)
Respiration Suspended
Positioning
Erect
  • Patient standing with back to upright bucky
  • Make sure the patient is standing straight with no tilt of the upper mid-coronal plane
  • Turn the patient toward the affected side to get the glenoid cavity in profile profile. The amount of obliquity varies between patients, palpating the coracoid process and acromion angle and turning the patient until these are super-imposed, it is often in the range of 35° to 45°
  • The body of the scapular should be parallel with the IR
  • The humeral head should be in contact with the IR
  • Internally rotate the arm (the opposite to an AP projection (see Shoulder - AP)
May be performed supine
Critique

 Positioning
Correct obliquity of the patient is evidenced by:
  • The anterior and posterior rims of the glenoid cavity are super-imposed
  • The glenohumeral joint is exhibited open
  • Lateral aspect of the coracoid process slightly super-imposes humeral head
Correct amount of caudal angling is evidenced by:
  • Clear view of acromion space
Area Covered
  • Glenohumeral joint, humeral head, proximal humerus, acromion, acromion space, coracoid process, distal clavicle
Collimation
Exposure
  • Bony trabeculation and cortical outlines are sharply defined
  • Soft tissues are visualised
Special Notes