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Location: Scapula - Lateral
Discussion: Can anyone tell me the best way to position for a scapular Y view?
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Posted Anonymously |
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M.J.Fuller |
1. RE: Can anyone tell me the best way to position for a scapular Y view?
Jul 17 2008, 11:23 PM EDT
This is one of those difficult techniques to master. You will find that every radiographer will show you a different technique. Pick the one that works for you. I prefer the "Napoleon" position. I have posted what I think are the most common three approaches for ambulant patients here http://www.wikiradiography.com/page/Lateral+Scapula+Radiography. I will complete this page soon.M.J.Fuller 3 out of 3 found this valuable. Do you? |
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Posted Anonymously |
2. RE: Can anyone tell me the best way to position for a scapular Y view?
Jul 29 2008, 9:36 AM EDT
Personally I dislike the Napoleon view. I agree it is easy to do, but I don't like the humerus being projected over the ribcage. I like it lateral to the ribs where it is supposed to be.
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M.J.Fuller |
3. RE: Can anyone tell me the best way to position for a scapular Y view?
Jul 30 2008, 9:11 PM EDT
"Personally I dislike the Napoleon view. I agree it is easy to do, but I don't like the humerus being projected over the ribcage. I like it lateral to the ribs where it is supposed to be."Anonymous, I appreciate that you have a dislike for projecting the humerus over the ribs on the lateral scapula view. The success or legitimacy of a particular technique should be measured by the degree to which it meets your objectives. If one of your objectives is to clearly visualize the proximal third of the humerus on lateral scapula view, this objective should be taken into consideration. There are of course multiple objectives- minimising radiation dose to the patient, reproducibility, easy of positioning, adaptability to different patients and patient abilities etc. The advantage of a website like this (as opposed to a textbook) is that you have the ability to gain an appreciation of what other radiographers are doing and share information and ideas. Radiographers are able to share that pragmatic wisdom that only comes from years of experience. All radiography textbooks I have read offer alternative techniques to achieve a particular demonstration of anatomy. K.C. Clarke’s "Positioning in Radiography" suggests that the arm position for the lateral scapula should be either "...moved forward across the trunk" or "...moved away from the trunk with slight abduction and flexion of the elbow" (9th ed, p 66) We all tend to adopt particular radiographic techniques and practices like a favourite recipe. The longer we adhere to a particular technique, the more convinced we become that it is the correct and only way (I am no exception to this phenomenon). Radiographer's assessments of techniques tend to be more experiential than experimental, and I see nothing wrong with that per se. To return to your comment, I appreciate your effort in making your preference known. I assume that your dislike of the “Napoleon” technique is based on an objective of maximizing the demonstration the proximal humerus on the lateral scapula view. Cheers, M.J. Fuller 1 out of 3 found this valuable. Do you? |
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Posted Anonymously |
4. RE: Can anyone tell me the best way to position for a scapular Y view?
Jul 31 2008, 8:57 AM EDT
sounds very much like a long winded way of saying "don't argue with me".there is nothing wrong with the napoleon view. it meets all of the criteria you outlined above. i just don't like it, and i find my patients prefer the option that requires the least amount of movement. the advantage of a forum like this is that anyone can share their opinions without necessarily answering the original question or providing anything overly constructive to the conversation. 2 out of 7 found this valuable. Do you? |
mrenfinger |
5. RE: Can anyone tell me the best way to position for a scapular Y view?
Nov 7 2008, 5:49 AM EST
"sounds very much like a long winded way of saying "don't argue with me".It doesn't seem like M.J. is saying "don't argue with me" at all... he simply put his preferred method in there in response to a question, someone disagreed, and then he encouraged utilization of whatever method works for the technologist, pointing out that there are so many ways to do it. In the event you did not write the original post, I prefer to place a 45 degree sponge behind the patient (supine or standing), center about 2" distal to the humeral head, collimate to the humerus to increase contrast, and set 3X the mAs of the AP view, but that's what I prefer to do. Here's a good method for trauma if a patient is on a backboard, but you will get elongation: http://bloggingradiography.blogspot.com/2007/04/trauma-y-shoulder.html 3 out of 3 found this valuable. Do you? |
11B |
6. RE: Can anyone tell me the best way to position for a scapular Y view?
Dec 7 2008, 4:35 PM EST
The original question was for help with the "Y" view of the scapular. I use the standing Napoleon position with a 15 degree caudal angle through the head of the humerus to show the space over the top of the humeral head. It is imperative that the body of the scapular is clear of the rib cage and projected in profile (ie perfectly lateral). You will have trouble with excessively muscular men, those with excessively rotund abdomens or ladies with very large breasts, and kyphitic people. Make what ever postural adjustments are neccessary with the aid of sponge blocks to get the scapular vertical and perpendicular to the vertical bucky. As for the lateral scapular view, I do mine AP with the forearm lying on top of the head along the sagital plane, patient rotated to the point where thr scapular is clear of the rib cage and using central beam perpendicular to the cassette.
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