Humerus and Shoulder Study

Question 1

Which of the following technical considerations does not apply for adult shoulder radiography?

nongrid
high-speed IR
40- to 44-inch SID
70- to 80-kVp

Answer 1

nongrid

Question 2

Gonadal shielding should be used for children and adults of childbearing age.

Answer 2

true

Question 3

What is the greatest technical concern during a pediatric shoulder study?

Answer 3

voluntary motion

Question 4

What modality or procedure provides a functional, or dynamic study of the shoulder joint?

Answer 4

ultrasound

Question 5

What imaging modality or procedure best demonstrates osteomyelitis?

Answer 5

nuclear medicine

Question 6

What is an alternative CR centering for an AP shoulder projection on an obese patient if unable to palpate the coracoid process?

Answer 6

center 2 inches below AC joint

Question 7

What type of compensating filter is recommended for use on an AP shoulder projection for a hypersthenic patient?

Answer 7

boomerang

Question 8

What routine projection of the shoulder requires that the humeral epicondyles be parallel to the IR?

anterior oblique (Grashey method)
internal rotation
external rotation
neutral rotation

Answer 8

external rotation

Question 9

Where is the CR centered for an AP projection— external rotation of the shoulder?

acromion
1 inch superior to coracoid process
1 inch inferior to coracoid process
2 inches inferior to AC joint

Answer 9

1 inch inferior to coracoid process

Question 10

What position of the shoulder and proximal humerus projects the lesser tubercle in profile medially?

Answer 10

internal rotation

Question 11

How are the humeral epicondyles aligned for a rotational lateromedial projection of the humerus?

Answer 11

perpendicular to IR

Question 12

For the erect version of the tangential projection for the intertubercular sulcus, the patient leans forward _______ from vertical.

Answer 12

10 to 15°

Question 13

What’s the major advantage of the supine, tangential version of the intertubercular sulcus projection over the erect version?

less radiation exposure
reduced OID
less risk for motion
ability to use automatic exposure control

Answer 13

reduced OID

Question 14

What projection best demonstrates the supraspinatus outlet region?

Answer 14

tangential projection (Neer method)

Question 15

What projection can an orthostatic (breathing) technique be used?

Answer 15

transthoracic lateral for humerus

Question 16

Which anatomy of the shoulder is best demonstrated with a PA axial (Bernageau method)?

Answer 16

scapulohumeral joint space

Question 17

Which projection requires the CR to be centered 2 inches inferior and medial from the superolateral border of the shoulder?

posterior oblique (scapula Y lat.)
anterior oblique (Grashey method)
inferosuperior axial (Clements)
tangential proj. (fisk modification)

Answer 17

anterior oblique (Grashey method)

Question 18

What type of injury must be ruled out before the weight-bearing phase of an AC joint study?

Answer 18

fractured clavicle

Question 19

What is the minimal amount of weight a large adult should have strapped to each wrist for the weight-bearing phase of an AC joint?

Answer 19

8-10 lbs

Question 20

Why is it recommended for adult AC joint studies to use a 72-inch SID?

Answer 20

to get both joints

Question 21

What two landmarks are aligned perpendicularly to the IR for the lateral scapula projection?

Answer 21

superior angle and AC joint

Question 22

What device permits good visualization of soft-tissue and bony anatomy for adult shoulder radiography?

Answer 22

boomerang compensating filter

Question 23

The parent or guardian can be asked to restrain a child for a shoulder series if physical immobilization is required.

Answer 23

true

Question 24

Radiography is more sensitive than nuclear medicine for demonstrating physiologic aspects of the shoulder girdle.

Answer 24

false

Question 25

It is recommended to perform shoulder positions on obese patients in the erect position when possible.

Answer 25

true

Question 26

CT arthrography of the shoulder joint often requires iodinated contrast media injected into the joint space.

Answer 26

true

Question 27

Which lateral projection can demonstrate the entire humerus?

Answer 27

transthoracic lateral

Question 28

The _______________ projection of the shoulder produces an image of the glenoid process in profile.

This is also called the ________ method.

Answer 28

AP oblique

Grashey

Question 29

What two landmarks are placed perpendicular to the IR for the scapular Y lateral projection>

Answer 29

superior angle of scapula
AC joint articulation