Clavicle Comp Flashcards
What happens when the patient is rotated towards the affected shoulder?
The medial end of the clavicle is drawn away from the vertebral column
The clavicle is longitudinally foreshortened
Where do 80% of fractures occur?
The middle 1/3rd
Where do 15% of fractures occur?
The lateral 1/3rd`
The superior scapular angle is superior to clavicle. What positioning error has occured?
The upper MCP is tilted anteriorlyq
What does the axial clavical demonstrate?
Non-displaced fractures that can’t be demonstrated on the AP due to overlap of scapula and ribs
How much and why do we angle for an AP axial clavicle?
15-30 degrees cephalad to throw the clavicle off of the thorax and demonstrate a fracture displacement
How to angle for thinner patients?
10-15 degrees more angle
How do you angle if a patient has a natural slouch/kyphotic?
Angle more
How do you know your angle is correct for an AP axial clavicle?
The lateral and middle 1/3rds are superior to thorax and scapula
How many curves does the clavicle have?
2
Parts of the clavicle?
- Sternal (medial) extremity (end)
- Acromial (lateral) extremity (end)
- Body
What form the jugular notch?
The sternoclavicular joints and the manubrium
What is the acromial end of the clavicle like?
Downward curvature, flattened
What is the sternal end of the clavicle like?
Directed downward, triangular shaped
Female clavicles
Shorter
Less curved
Male clavicles
Thicker
More curved, most curved in heavily muscled men
What does the shoulder girdle consist of?
- AC joint
- SC joint
- Scapulohumeral joint
What makes up the shoulder girdle?
The clavicle and scapula
What is the shoulder girdle for?
Connect each upper extremity with the trunk/axial skeleton
Classification of all joints of the shoulder girdle?
Synovial
Diarthrodial
Classification of the scapulohumeral joint?
- Spheroidal/ball and socket
- Flexion/extension, adduction/abduction, circumduction, med/lat rotation
Classification of the sternoclavicular joint?
- Double plane/gliding
- Limited gliding movement
Classification of the acromialclavicular joint?
- Plane/gliding
- Gliding/secondary rotary movement
Why is the SC joint classed as a double plane joint?
It articulates with the manubrium and cartilage of the first rib
Why does the AC joint have a secondary rotary movement?
To allow the scapula to adjust its position to remain in close contact with the posterior chest wall
Which way would you angle for a PA projection?
Caudad to throw everything behind the clavicle downwards
AC joint dislocation?
Distal clavicle is displaced superiorly, most commonly from a fall
AC joint separation?
Partial/complete tear of AC or coracoclavicular ligament or both
Bankart lesion?
Possible small avulsion fracture of the anteriorinferior glenoid rim
Bursitis?
Inflammation of the bursae, formation of calcifications in associated tendons
Technique for clavicle?
75-85 kVp
3 mAs
How much do we rotate the patient for SC joint obliques?
10-15 degrees
What happens to the upside SC joint when you perform an SC joint oblique?
It is foreshortened
What happens with only 5-10 degrees obliquity on an SC joint oblique?
The opposite SC joint would be visualized next to the vertebral column
How much weight do we use for AC joints weightbearing?
8-10lbs
5-8lbs for smaller people
Lateral end of the clavicle and acromion apex demonstrate slightly greater AC joint space?
Patient rotated (a little) away from affected AC joint
Lateral end of the clavicle and acromion apex demonstrate closed joint space?
Patient rotated (a lot) away from affected AC joint
Increased superimposition of the clavicle and acromion and superior scapular angle is superior to the clavicle?
The MCP is tilted anteriorly
Lateral end of clavicle and acromion are rotated out of profile and the AC joint is closed? (Increased amount of scapula and thorax superimposition)
Patient is rotated towards affected side
Normal AC joint space?
0.3cm (.125”)
What do we do differently for bilateral AC joints? Why?
183 SID to reduce magnification and allow both joints to fit on the IR
AP Axial AC joints (alexander method)?
15 deg cephalad angle
