Shoulder - NeersThis is a featured page

Radiographic Positioning


Adult
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Name of projection Shoulder - Neers
Area Covered "Out-let" view for area under coracoacromial arch or supraspinatus outlet, inlcudes humeral head, glenoid, acromion, lateral clavicle, superior scapula
Pathology shown Spurs, calcifications, impingement on supraspinatus outlet, shape of acromion
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
Filter No
Exposure 75 kVp
25 mAs
FFD / SID 100cm
Central Ray CR angled 10° to 15° caudal (to show supraspinatus outlet)
Directed to exit at the superior part of the humeral head
Collimation Centre: Superior part of medial border of scapula (to exit at superior portion of humeral head)
Shutter A: Above acromion process and lateral clavicle
Shutter B: Skin line
Markers Lateral and superior
Marker orientation is PA
Shielding Gonadal (check your department's policy guidelines)
Respiration Suspended
Positioning
  • Patient standing upright facing the bucky
  • Arm straight at side or slightly abducted
  • Rotate the patient so that the affected shoulder is toward the bucky
  • Obliquity required is between 45° to 60° and depends on the patient
  • The aim is to make the body of the scapula perpendicular to the bucky
  • Centre so the acromion of the affected shoulder is in the middle of the bucky
Critique

 Positioning

  • Acromioclavicular joint should be in the midline
  • Humeral head directly below acromioclavicular joint
  • Correct obliquity of the patient is evidenced by
    • The body of the scapula is in a lateral position (shown by super-imposition of the medial and lateral borders of the body of the scapula)
    • Body of the scapula, acromion and coracoid processes form a "Y" with the glenoid at its convergen (see note below)
  • Correct central ray angulation is evidenced by
    • Clear view through the supraspinatus outlet, beneath the coracoacromial arch (see note below)
Area Covered

  • Clear supraspinatus outlet, acromioclavicular joint, humeral head, superior scapula in a lateral position
Collimation

  • Centre: Humeral head
  • Shutter A: Above acromion process and lateral clavicle
  • Shutter B: Skin-line
Exposure
  • Bony trabecular patterns and cortical outlines are sharply defined
  • Soft tissues are visualised
Special Notes Detecting incorrect obliquity


Detecting incorrect central ray angulation



AndyC
AndyC 		Latest page update: made by AndyC , Jun 18 2011, 10:53 AM EDT (about this update About This Update AndyC Edited by AndyC

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