Scapula, AC Joint and Clavicle Flashcards
What are the projections of the clavicle?
AP
AP Axial
PA
PA Axial
Clavicle - AP Projection
Upright or recumbent
CR - perpendicular
CP - middle of clavicle
Suspend on inspiration
Why do you suspend on inspiration for an AP Clavicle Projection?
so that the clavicle is as high off the ribs as it can be
Clavicle -AP Evaluation criteria
Entire clavicle visualized and centered
uniform density
lateral aspect above humerus
medial aspect superimposing the thorax
Clavicle - AP Axial Projection
Upright or recumbent
CR - 15-30 degrees cephalad
- asthenic patients would require more angulature
Suspend on inspiration
secondary marker of up arrow signalling axial
Clavicle - AP Axial Evaluation criteria
Entire clavicle visualized
majority of clavicle above scapula/ribs
medial end superimposing second rib
clavicle is more horizontal
What are the benefits/downsides to performing PA clavicle projections? What would the CR angle be?
OID is smaller, less radiation to thyroid
more painful for patient
15-30 degrees caudad
How do you image pedicatric clavicle?
supine for immobilization
bilateral for comparison
AC Joint - AP projection
Upright in true AP
CP - MSP at level of AC joint
suspend on exhilation
Use both R and L markers (WW or weights)
Thyroid and gonadal sheilding
180cm SID
1 with and 1 without weights
AC Joint- AP Evaluation criteria
both joints included, with and without weights
no rotation or leaning
if present, joint separation seen clearly on image with weights
no shrugging - arms relaxed down with weights
AC Joint- AP Unilateral
4 images required
- with and without for each joint
- still give both weights
- maintain SID
- LPO or RPO depending on side
Thyroid collar not required
15X20cm FOV
Scapula - AP Projection
Abduct arm to a right angle with body
Include all of scapula
Shallow breathing technique
- increase time, reduce mA
Scapula - AP evaluation criteria
Lateral portion of scapula free from superimposition
Scapula slightly obliqued
No lung markings
Scapula - Lateral (Y)
Oblique to align acromion and medial scapula (45-60 degrees) arm out of way
AP or PA oblique
- marker and shield correctly orriented
Suspend respiration
Scapula - Lateral (Y) evaluation criteria
No superimposition of scapular body over bony thorax
No superimposition of humerus over scapula
Lateral scapula
humeral head and glenoid between coracoid and acromion