Shoulder

Question 1

What does the shoulder girdle consist of?

Answer 1

the clavicle and the scapula

Question 1

What does the shoulder articulate with?

Answer 1

the head of the humerus laterally (shoulder joint)

manubrium of sternum medially (sternoclavicular joint)

each other lateral (acromioclavicular joint

Question 2

What is the function of the shoulder girdle?

Answer 2

functions to connect the upper limb to the trunk of the body

Question 3

is the shoulder considered to be a part of the of the shoulder girdle?

Answer 3

no because the upper portion articulates with the shoulder girdle, proximal humeral anatomy is considered in evaluation images of the shoulder joint

Question 4

What artifacts should be removed for a shoulder image?

Answer 4

jewelry, artifacts on clothing

Question 5

whats the general patient position and what should you take into consideration when positioning the patient?

Answer 5

shoulder procedures can be performed in upright or recumbent positions

consider patient comfort first

Question 6

What should the IR/collimation size be for shoulder and clavicle?

Answer 6

10 x 12 inches crosswise

Question 7

what should the IR/collimation be for a scapula image?

Answer 7

10 x 12 inches lengthwise

Question 8

Whats the standard SID for a shoulder image?

Answer 8

40 inches

Question 9

What are the essential projections for a shoulder image?

Answer 9

AP internal rotation, AP external rotation, AP neutral position, PA oblique (scapular Y)

Question 10

What should the part position be like for a shoulder?

Answer 10

shoulder joint centered

flex elbow slightly

rotate arm internally and rest hand on back of hip

place humeral epicondyles perpendicular to ir

Question 11

Where should the CR enter the patient for an AP projection in internal rotation?

Answer 11

1 inch inferior to coracoid process

Question 12

What should the collimation be for an AP projection in internal/neutral/external rotation?

Answer 12

10 x 12 inches

collimation should be 1.5 inches above shoulders and 1 inch beyond the lateral aspect of the shoulder, sternal end of the clavicle and the proximal third of the humerus

Question 13

What structures should be shown in an AP projection in internal rotation shoulder image?

Answer 13

the bony and soft tissue structures of the shoulder and proximal humerus

Question 14

What’s the evaluation criteria for an AP internal rotation shoulder image?

what should be in profile?
what should be outlined?
think about the humerus

Answer 14

Lesser tubercle seen in profile and pointing medially

outline of greater tubercle superimposing humeral head

greater amount of humeral overlap of the glenoid cavity than in external and neutral positions

Question 15

Eval: what happens to the glenoid cavity in an AP internal rotation vs in the external and neutral positions?

Answer 15

there is a greater amount of humeral overlap of the glenoid cavity in the internal rotation

Question 16

whats the part position like for an AP shoulder external rotation?

hint:
elbow
arm
humeral epicondyles

Answer 16

abduct arm slightly

flex elbow slightly

rotate arm externally and supinate hand

place humeral epicondyles parallel to ir

Question 17

Where should the CR enter for an Ap shoulder in external rotation?

Answer 17

1 inch inferior to coracoid process

Question 18

what is the collimation for an Ap shoulder in external rotation?

Answer 18

10 x 12 inches crosswise

Question 19

Eval: what should be in profile for an Ap shoulder in external rotation?

Answer 19

the humeral head

greater tubercle on lateral aspect of humerus

Question 20

structures shown: what structures should be show in an Ap shoulder external rotation?

Answer 20

superior scapula, clavicle, and proximal humerus

Question 21

eval: what joint space should be seen in an AP shoulder external rotation?

Answer 21

the scapulohumeral joint should be seen with slight overlap of the humeral head on glenoid cavity

Question 22

eval: what part of the tubercle should be seen in an ap shoulder external rotation?

Answer 22

the outline of the lesser tubercle should be seen between the humeral head and greater tubercle

Question 23

What is the Ap neutral shoulder position used for?

Answer 23

for trauma cases

Question 24

Evaluation criteria for a AP neutral shoulder

Answer 24

greater tubercle partially superimposing the humeral head

humeral head should be seen in partial profile

slight overlap of the humeral head and glenoid should be seen

Question 25

What position is useful to diagnose shoulder dislocations?

Answer 25

PA oblique scapular Y

Question 26

What should the patients position be for a PA oblique scapular y?

Answer 26

upright or recumbent

RAO or LAO

Question 27

What side should be closer to the IR for a PA oblique scapular y?

Answer 27

the affected side

Question 28

Where should the central ray enter for a PA oblique scapular Y?

Answer 28

perpendicular to scapulohumeral joint

Question 29

What should the collimation be for a PA oblique scapular Y?

Answer 29

10 x 12 LENGTHWISE

1 inch beyond the lateral shadow

Question 30

What structures are shown in a PA oblique scapular Y?

Answer 30

humeral head is directly superimposed over the junction of the Y

Question 31

What happens to the humeral head and glenoid cavity in a PA oblique scapular Y

Answer 31

they are superimposed

Question 32

What happens to the humeral shaft and scapular body during a PA oblique scapular Y

Answer 32

they are superimposed

Question 33

Where should the acromion be if a PA oblique scapular Y is done correctly?

Answer 33

The acromion should be projected laterally and free of superimposition

Question 34

Where should the scapula appear in a PA oblique scapular Y image?

Answer 34

in lateral profile with lateral and vertebral borders superimposed