Shoulder Analysis

Question 1

What projection is a grid not used for?

Answer 1

Inferosuperior

Question 2

What kvp is used for most shoulder projections?

Answer 2

75-85

Question 3

What kvp is used for AC joint projections?

Answer 3

70-80

Question 4

What SID is used for bilateral AC joints?

Answer 4

183cm

Question 5

What projections use 3 mAs instead of 5?

Answer 5

Clavicle, AC joint

Question 6

T/F
On the AP neutral projection, some overlap of the numeral head and glenoid should be seen

Answer 6

True

Question 7

How can you determine if a patient is rotated towards the affected side, placing the shoulder closer to the IR?

Answer 7

-increased thoracic superimposition over scapular body
-increased clavicular foreshortening
-medial end of clavicle rotates away from the lateral edge of the vertebral column

Question 8

What is the positional error if a patients medial end of the clavicle is superimposed on the vertebral column?

Answer 8

Patient is rotated away from affected side

Question 9

What is the positional error if the superior scapular angle is seen superior to the mid clavicle?

Answer 9

Anterior MCP tilting

Question 10

What is the positional error if the superior scapular angle is seen inferior to the mid clavicle?

Answer 10

Posterior MCP tilting

Question 11

In a kyphotic patient, where will the superior scapular angle be situated?

Answer 11

Superior to the midclavicle

Question 12

What type of scapular foreshortening will be present on a kyphotic person?

Answer 12

Longitudinal and transverse foreshortening

Question 13

What is one method of alternate positioning for a kyphotic patient?

Answer 13

Angle the CR cephalon until it is perpendicular with the scapular body

Question 14

What degree of rotation is used for the AP oblique grashey projection?

Answer 14

35-45 degrees
Toward affected side

Question 15

T/F
The anterior and posterior rims of the glenoid cavity should be superimposed in a AP oblique grashey projection?

Answer 15

True
Should be in profile without thoracic superimposition

Question 16

How much of the coracoid should be superimposing the numeral head in a AP oblique grashey projection?

Answer 16

0.6cm

Question 17

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

Answer 17

True

Question 18

T/F
The glenohumeral joint space should be open in a AP oblique grashey projection

Answer 18

True

Question 19

How is the patients scapula positioned in an AP oblique grashey projection?

Answer 19

Parallel with the IR
(Accomplished by rotating 35-45 degrees)

Question 20

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?

Answer 20

Excessive obliquity

Question 21

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?

Answer 21

Insufficient rotation

Question 22

T/F
A kyphotic patient will require increased obliquity to position the glenoid cavity in profile?

Answer 22

True
The resulting projection will demonstrate the thorax closer to or superimposed over the glenohumeral joint space

Question 23

What happens to the scapula when the shoulder is protracted?

Answer 23

The scapula glides around the thorax, moving it anteriorly

Question 24

Where will the humeral head be seen with an anterior dislocation?

Answer 24

Below the coracoid process

Question 25

Where will the humeral head be seen with a posterior dislocation?

Answer 25

Below the acromion

Question 26

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

Answer 26

Excessive obliquity

Question 27

In a PA oblique scapular Y projection, what is the positional error if the clavicle is seen superior to the superior scapular angle?

Answer 27

The patient is leaning away from the IR

Question 28

To better demonstrate the scapula on a kyphotic patient in PA, what direction of angulation is used?

Answer 28

Caudad

Question 29

To better demonstrate the scapula of a kyphotic patient in AP, what direction of angulation is used?

Answer 29

Cephalad

Question 30

In which projection is the coracoid process in profile?

Answer 30

Inferosuperior axial

Question 31

In which projection is the AC joint, acromion, and criminal end of the clavicle projected through the humeral head?

Answer 31

Inferosuperior axial

Question 32

If the lesser tubercle is seen in profile anteriorly on a inferosuperior axial projection, what position were the epicondyles in relation to the floor?

Answer 32

Parallel (Hand supinated)

Question 33

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?

Answer 33

45 degrees External rotation ( lat epicondyle is closer to the floor)

Question 34

If the greater tubercle is seen partially in profile anteriorly on an inferosuperior projection, how are the epicondyles positioned in relation to the floor?

Answer 34

45 degrees Internal rotation (medial epicondyles is closer to the floor)

Question 35

If the greater tubercle is seen partially in profile posteriorly on a inferosuperior projection, how are the epicondyles situated in relation to the floor?

Answer 35

Perpendicular to the floor External rotation

Question 36

If you have 90 degrees arm abduction for an inferosuperior, how much tube angulation is needed?

Answer 36

30-35 degrees

Question 37

If you have between 60-90 degrees of abduction for an inferosuperior, what degree of tube angulation is needed?

Answer 37

20-35 degrees

Question 38

If you have 60 degrees of abduction for an inferosuperior, what degree of tube angulation is needed

Answer 38

20 degrees

Question 39

What is the positional error for an inferosuperior if the inferior margin of the glenoid is projected lateral to the coracoid?

Answer 39

Insufficient angulation

Question 40

What is the positional error for an inferosuperior if the inferior margin of the genius is projected medial to the coracoid?

Answer 40

Excessive angulation

Question 41

What projection id the humerus abducted to 90 degrees?

Answer 41

AP scapula

Question 42

In what projection is the superior scapular angle seen slightly inferior to the clavicle (arm abduction)

Answer 42

AP scapula

Question 43

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?

Answer 43

Tilted towards IR (posteriorly)

Question 44

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?

Answer 44

Tilted away from IR (anteriorly)

Question 45

Whag can be done to correct the scapular body in a kyphotic patient for an AP scapula?

Answer 45

Angle CR cephalically until perpendicular with scapular body

Question 46

Why is an ortho static breathing technique used for an AP scapula?

Answer 46

Low mA High time Will blur lung markings and ribs to see scapula better

Question 47

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

Answer 47

True

Question 48

T/F For a clavicle projection, the mid clavicle should be superimposed on the superior scapular angle

Answer 48

True

Question 49

Where is the medial end of the clavicle seen with rotation toward the affected side?

Answer 49

Away from vertebral column

Question 50

Where is the medial end of the clavicle seen with rotation away from the affected side?

Answer 50

Superimposed on vertebral column

Question 51

What ribs does the medial end of the clavicle superimpose on an axial projection?

Answer 51

1st-2nd

Question 52

T/F The clavicle bows upwards on an AP axial

Answer 52

True

Question 53

What angulation is used for axial clavicle?

Answer 53

15-30 degrees

Question 54

T/F A smaller angle (15) is used for hyperstenic patients in axial clavicle projections?

Answer 54

True

Question 55

T/F A larger angle (30) is used for asthenic patients in axial clavicle projections

Answer 55

True

Question 56

T/F 95% of shoulder dislocations are anterior

Answer 56

True

Question 57

What is the difference between osteoarthritis and rheumatoid arthritis?

Answer 57

OA - non inflammatory, gradual deterioration of cartilage with hypertrophic bone formation RA - inflammatory changes occurring throughout the body’s connective tissue

Question 58

Idiopathic Chronic Adhesive Capsulitis

Answer 58

Frozen shoulder

Question 59

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

Answer 59

Hill-Sachs deformity

Question 60

What projection/position will demonstrate Hill-Sachs deformity?

Answer 60

Inferosuperior with external rotation

Question 61

Fracture of the anteroinfeeior glenoid rim

Answer 61

Banker lesion

Question 62

What rim of the glenoid fossa will superimpose the humeral head on an AP shoulder projection?

Answer 62

Posterior rim