Shoulder AP + diseases

Question 1

AP projection - positioning

Answer 1

18-24 cm casette
Pt erect. 
AP.
100 ffd
exposure 70 - 8/12 mAs
wall bucky, no AEC, fine focus
handspan collimation
angle 15-20 degrees caudal
center 1" below coracoid - soft part below AC
scapula parallel to the IR
humerus 'parallel' to the IR
forearm over tummy

Question 2

AP projection critique

Answer 2

ANATOMY - name all
Positioning critique - Include soft tissue and boney detail. No burn out of soft tissue. This veiw opens the sub-acromial space and demonstrates ossification of the coracoacromial ligament. It shows a tongue of bone from the anterioracromical of the acromion process. + other lesions.

Question 3

Explain what type of exposure would you like

Answer 3

High contrast image to have a distinguishing factor between bone and soft tissue. Looking for calcification iwth tendons as well as bony abnormalities. Must ensure soft tissue isn’t burnt out.

Question 4

Bursitis

Answer 4

inflammation of the bursa or fluid filled sacs. Formation of calcification with associated tendons -> pain and limitation of the joint.

Question 5

Bankart Lesion

Answer 5

antero-inferior glenoid rim fracture. Seen on axial and westpoint views.

Question 6

Hill-Sachs defect

Answer 6

COMPRESSION fracture of articular surface of the humeral head due to anterior dislocation of the humeral head. Seen on axial and stryker’s views.

Question 7

Frozen Shoulder (Idiopathic Chronic Adhesion capsulitis)

Answer 7

Chronic inflammation in and around joint. Pain and limitation. Calcification or other joint space abnormality. 2-3years resolving time.

Question 8

Rotator cuff tear

Answer 8

tear in rotator cuff muscles. limitation of motion of shoulder, migration of humeral head superiorly. Closing space between the humeral head and acromion.

Question 9

Tendonitis

Answer 9

calcified tendons - inflammatory due to a strain
acute - soft and fluffy
chronic - dense

Question 10

Impingement syndrome

Answer 10

encroachment of supraspinatous muscle tendon anteriorly on anterior acromion when arm is abducted causing subacromial spurs. Thickening of subacromial or subdeltoid bursa. This is due to repetitive use of abduction. It is also called painful arc syndrome. You can get rotator cuff tears from this.