Shoulder Analysis Flashcards
What projection is a grid not used for?
Inferosuperior
What kvp is used for most shoulder projections?
75-85
What kvp is used for AC joint projections?
70-80
What SID is used for bilateral AC joints?
183cm
What projections use 3 mAs instead of 5?
Clavicle, AC joint
T/F
On the AP neutral projection, some overlap of the numeral head and glenoid should be seen
True
How can you determine if a patient is rotated towards the affected side, placing the shoulder closer to the IR?
-increased thoracic superimposition over scapular body
-increased clavicular foreshortening
-medial end of clavicle rotates away from the lateral edge of the vertebral column
What is the positional error if a patients medial end of the clavicle is superimposed on the vertebral column?
Patient is rotated away from affected side
What is the positional error if the superior scapular angle is seen superior to the mid clavicle?
Anterior MCP tilting
What is the positional error if the superior scapular angle is seen inferior to the mid clavicle?
Posterior MCP tilting
In a kyphotic patient, where will the superior scapular angle be situated?
Superior to the midclavicle
What type of scapular foreshortening will be present on a kyphotic person?
Longitudinal and transverse foreshortening
What is one method of alternate positioning for a kyphotic patient?
Angle the CR cephalon until it is perpendicular with the scapular body
What degree of rotation is used for the AP oblique grashey projection?
35-45 degrees
Toward affected side
T/F
The anterior and posterior rims of the glenoid cavity should be superimposed in a AP oblique grashey projection?
True
Should be in profile without thoracic superimposition
How much of the coracoid should be superimposing the numeral head in a AP oblique grashey projection?
0.6cm
T/F
The superior margin of the coracoid process should be aligned with the superior margin of the glenoid cavity in a AP oblique grashey projection
True
T/F
The glenohumeral joint space should be open in a AP oblique grashey projection
True
How is the patients scapula positioned in an AP oblique grashey projection?
Parallel with the IR
(Accomplished by rotating 35-45 degrees)
What is the positional error if the thorax demonstrates increased superimposition over the glenoid cavity and the scapular neck in an AP oblique grashey projection?
Excessive obliquity
What is the positional error if the lateral tip of the coracoid demonstrates less than 0.6cm of numeral head superimposition on an AP oblique grashey projection?
Insufficient rotation
T/F
A kyphotic patient will require increased obliquity to position the glenoid cavity in profile?
True
The resulting projection will demonstrate the thorax closer to or superimposed over the glenohumeral joint space
What happens to the scapula when the shoulder is protracted?
The scapula glides around the thorax, moving it anteriorly
Where will the humeral head be seen with an anterior dislocation?
Below the coracoid process
Where will the humeral head be seen with a posterior dislocation?
Below the acromion
In a PA oblique scapular Y, what is the positional error if the lateral border is superimposed by the thorax or closer to the thorax
Excessive obliquity
In a PA oblique scapular Y projection, what is the positional error if the clavicle is seen superior to the superior scapular angle?
The patient is leaning away from the IR
To better demonstrate the scapula on a kyphotic patient in PA, what direction of angulation is used?
Caudad
To better demonstrate the scapula of a kyphotic patient in AP, what direction of angulation is used?
Cephalad
In which projection is the coracoid process in profile?
Inferosuperior axial
In which projection is the AC joint, acromion, and criminal end of the clavicle projected through the humeral head?
Inferosuperior axial
If the lesser tubercle is seen in profile anteriorly on a inferosuperior axial projection, what position were the epicondyles in relation to the floor?
Parallel
(Hand supinated)
If the lesser tubercle is seen partially in profile anteriorly on an inferosuperior projection, what is the position of the epicondyles in relation to the floor?
45 degrees
External rotation ( lat epicondyle is closer to the floor)
If the greater tubercle is seen partially in profile anteriorly on an inferosuperior projection, how are the epicondyles positioned in relation to the floor?
45 degrees
Internal rotation (medial epicondyles is closer to the floor)
If the greater tubercle is seen partially in profile posteriorly on a inferosuperior projection, how are the epicondyles situated in relation to the floor?
Perpendicular to the floor
External rotation
If you have 90 degrees arm abduction for an inferosuperior, how much tube angulation is needed?
30-35 degrees
If you have between 60-90 degrees of abduction for an inferosuperior, what degree of tube angulation is needed?
20-35 degrees
If you have 60 degrees of abduction for an inferosuperior, what degree of tube angulation is needed
20 degrees
What is the positional error for an inferosuperior if the inferior margin of the glenoid is projected lateral to the coracoid?
Insufficient angulation
What is the positional error for an inferosuperior if the inferior margin of the genius is projected medial to the coracoid?
Excessive angulation
What projection id the humerus abducted to 90 degrees?
AP scapula
In what projection is the superior scapular angle seen slightly inferior to the clavicle (arm abduction)
AP scapula
What is the positional error of an AP scapula if there is more than 0.6 cm of distance between the superior scapular angle and the clavicle?
Tilted towards IR (posteriorly)
What is the positional error of an AP scapula if there is less than 0.6 cm of distance between the superior scapular angle and the clavicle?
Tilted away from IR (anteriorly)
Whag can be done to correct the scapular body in a kyphotic patient for an AP scapula?
Angle CR cephalically until perpendicular with scapular body
Why is an ortho static breathing technique used for an AP scapula?
Low mA
High time
Will blur lung markings and ribs to see scapula better
T/F
For a clavicle projection, the lateral half of the clavicle is seen above the scapula and the medial half is seen superimposing the thorax
True
T/F
For a clavicle projection, the mid clavicle should be superimposed on the superior scapular angle
True
Where is the medial end of the clavicle seen with rotation toward the affected side?
Away from vertebral column
Where is the medial end of the clavicle seen with rotation away from the affected side?
Superimposed on vertebral column
What ribs does the medial end of the clavicle superimpose on an axial projection?
1st-2nd
T/F
The clavicle bows upwards on an AP axial
True
What angulation is used for axial clavicle?
15-30 degrees
T/F
A smaller angle (15) is used for hyperstenic patients in axial clavicle projections?
True
T/F
A larger angle (30) is used for asthenic patients in axial clavicle projections
True
T/F
95% of shoulder dislocations are anterior
True
What is the difference between osteoarthritis and rheumatoid arthritis?
OA - non inflammatory, gradual deterioration of cartilage with hypertrophic bone formation
RA - inflammatory changes occurring throughout the body’s connective tissue
Idiopathic Chronic Adhesive Capsulitis
Frozen shoulder
A compression fracture of the articular surface on the posterolateral aspect of the humeral head often associated with an anterior dislocation of the humeral head
Hill-Sachs deformity
What projection/position will demonstrate Hill-Sachs deformity?
Inferosuperior with external rotation
Fracture of the anteroinfeeior glenoid rim
Banker lesion
What rim of the glenoid fossa will superimpose the humeral head on an AP shoulder projection?
Posterior rim
