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Radiographic Image Analysis - Chapter 5
AP SHOULDER IMAGE ANALYSIS GUIDELINES-
- scapular body demos minimal transverse _________________ and _____ of the scapular body is visualized without thorax __________________ -clavicle is demod with minimal longitudinal _________________ and with the medial clavicular end positioned net to the ___________ edge of the vertebral column -midclavicle superimposes the ___________ scapular angle - foreshortening, half, superimposition foreshortening, lateral superior non dislocated shoulder: glenoid cavity is partially demod with the humeral head where? - superimposing it dislocated shoulder: glenoid cality is partially demod with the humeral head positioned where? - inferior to the glenoid cavity neutral humerus: greater tubercle is partially seen in profile ___________ and the humeral head is partially seen in profile ___________ - laterally medially external rotation humerus: greater tubercle seen in profile ____________ and the humeral head is in profile ___________ - laterally medially internally rotated humerus: lesser tubercle seen in profile ___________ and the humeral head is _________________ by the greater tubercle - medially superimposed when the projection is obtained in a supine position there is greater shoulder _______________ in comparison to when there shoulder is obtained upright because of the gravitation pull placed on the shoulder and the degree of forced thoracic spinal straightening that occurs as the patient lies on the firm imaging table - retraction
____________ method is the preferred method because it causes shoulder retraction and the scapular body to be positioned more dearly parallel with the IR, demos decreased transverse foreshortening of the scapular body and glenoid cavity visualizaiton - supine when the patient is rotated ___________ the affected shoulder for an AP shoulder- this demos increased thoracic superimposition over the scapular body, and increased clavicular foreshortening, and the medial clavicular end rotates away from the lateral edge of the vetebral column - toward when the patient is rotated ________ from the affected shoulder for an AP shoulder- this demos decreased thoracic superimposition over the scapular body, decreased clavicular foreshortening, and the medial clavicular end superimposing the vertebral column - away for the AP shoulder- if the upper midcoronal plane is tilted _____________, the superior scapular angle will be demod superior to the mid clavicle on the projection - anteriorly for the AP shoulder- if the upper midcoronal plane is tilted ___________, the superior scapular angle will be deemed inferior to the mid clavicle on the projection - posteriorly if the patient demonstrates a kyphotic curvature what can be done to compensate for this? -
- use a cephalic angle -lean patients shoulders posteriorly to place midcoronal at an angle with the IR that brings the scapular body parallel with the IR and use a horizontal CR anterior dislocation of the shoulder, which is more common (_____%), results in the humeral head being demod ____________, beneath the ___________ process - 95% anteriorly coracoid posterior dislocation, which is more uncommon (-%) results in the humeral head being demod _____________, beneath the _______________ process or spine of the scapula - 2-4% posteriorly acromion what are the two views for an AP shoulder that would be ordered for shoulder mobility? - internal//external for the inferosuperior axial projection- to obtain an open glenohumeral joint space the CR must be aligned ___________ with the joint space and glenoid cavity - parallel INFEROSUPERIOR AXIAL SHOULDER IMAGE ANALYSIS GUIDELINES-
if the humerus is externally rotated more than needed to position the humeral epicondyles at a greater than 45degree angle with the floor, the lesser tubercle and posterior lateral humeral head ________ be demonstrated; instead, the ____________ ___________ will be demonstrated to some degree posteriorly with it being in profile if the epicondyles are positioned perpendicular to the floor - won't greater tubercle AP OBLIQUE SHOULDER (GRASHEY) IMAGE ANAYLSIS GUIDELINES- -glenoid cavity is demonstrated in ________ and the glenohumeral joint space is open -tip of the coracoid process is __________________ the humeral head by about ____ inch -glenoid cavity shown ________ thorax superimposition -clavicle is longitudinally _______________ and is horizontally situated -superior margin of the ___________ process is aligned with the superior margin of the __________ _________ - profile superimposing//. without foreshortened coracoid//glenoid cavity GRASHEY- if obliquity was excessive, the glenohumeral joint space is ________, more than ____ inch of the __________ tip of the coracoid process is superimposed over the humeral head, the thorax demos ___________ glenoid cavity and scapular neck superimposition, and the clavicle demos ______________ longitudinal foreshortening - closed//. lateral increased excessive GRASHEY- if the obliquity was insufficient, the glenohumeral joint space is ________, the lateral tip of the coracoid process demos ______ than .25 inch of humeral head superimposition, the thorax ______ superimposed over the scapular neck, and the clavicle demos _______ longitudinal foreshortening - closed less isn't little GRASHEY- if the upper midcoronal plane is tilted _____________, the superior margin of the coracoid process will be demonstrated inferior to the superior margin of the glenoid cavity - anteriorly GRASHEY- if the upper midcoronal plane is tilted _____________, the superior margin of the coracoid process will be demonstrated superior to the superior margin of the glenoid cavity - posteriorly
PA OBLIQUE SCAPULAR Y SHOULER IMAGE ANALYSIS GUIDELINES-
scapular body is in a ___________ projection, with superimposed lateral and vertebral scapular borders -scapular structures form a Y, with the scapular body as the ____ and the acromion and coracoid as the
-glenoid cavity is demod on end at the ______________ _______ of the arms and leg of the Y -scapula is demonstrated _________ longitudinal foreshortening -clavicle and superior scapular angle are visualized at the same _____________ level - lateral leg//arms converging point without transverse PA OBLIQUE SCAPULAR Y SHOULDER- -no injury; glenoid cavity and humeral head, and the scapular body and the humeral shaft are
-shoulder dislocation; glenoid cavity doesn't _______________ the humeral head -proximal humerus fracture; glenoid cavity _________________ the humeral head, but the scapular body _________ superimpose the humeral shaft - superimposed superimpose superimposes//doesn't SCAPULAR Y SHOULDER- if the lateral border is _______________ by the thorax or is positioned closer to the thorax than the vertebral border, the obliquity was excessive - superimposed SCAPULAR Y SHOULDER- if the vertebral border_______________ the thorax or is demonstrated closer to the thorax than the lateral border, patient obliquity was insufficient - superimposes SCAPULAR Y SHOULDER- when the patient is leaning toward the IR, the clavicle is demonstrated ___________ to the superior scapular angle - inferior SCAPULAR Y SHOULDER- when the patient is leaning away from the IR, the clavicle is demonstrated __________ to the superior scapular angle - superior AP AXIAL PROJECTION (STRYKER "NOTCH")- -the coracoid process is situated just ___________ to the conoid tubercle of the clavicle -only a small amount of the glenoid cavity is visualized -posterolateral asset of the humeral head is in profile ___________
TANGENTIAL SUPRASPINATUS OUTLET (NEER METHOD) IMAGE ANALYSIS
GUIDELINES-
-supraspinatus outlet is _______ and the inferior aspect of the lateral clavicle and acromion are demonstrated in profile -lateral clavicle and acromion process form a smooth _______________ arch -superior scapular angle is at the level of the ____________ process tip and is positioned about .5 inch inferior to the clavicle - open continuous coracoid AP CLAVICLE - -medial clavicular end lies next to the __________ edge of the vertebral column -clavicle and superior scapular angle are visualized at the same _______________ level - lateral transverse AP CLAVICLE - -if the patient is rotated _______ from the affected clavicle, the medial end of the clavicle is superimposed over the vetebral column - away AP CLAVICLE - if the patient is rotated ____________ the affected clavicle, the medial end of the clavicle draws away from the vertebral column and the clavicle is longitudinally foreshortened - toward AP CLAVICLE - if the upper midcoronal plane is tilted _______________, the superior scapular angle will be demonstrated superior to the clavicle - anteriorly AP CLAVICLE - if the upper midcoronal plane is tilted ________________, the superior scapular angle is shown inferior to the clavicle - posteriorly AP AXIAL CLAVICLE-
- medial clavicular end lies next to the ___________ edge of the vertebral column -superior scapular angle is visualized .5 inch __________ to the clavicle -medial end of clavicle is superimposed over the first, second, or third rib -middle and lateral thirds of clavicle are seen ______________ to the acromion process and the clavicle bows upwardly - lateral inferior superior _____% of clavicle fractures occur at the middle third and _____% at the lateral third - 80
AP AC JOINT -
-clavicle and the superior scapular angle are demonstrated at the same ______________ level - transverse AP SCAPULA IMAGE ANAYLSIS GUIDELINES- -anterior and posterior margins of the glenoid cavity are nearly ______________ -____________ scapular border is seen without thoracic cavity superimposition, while the thoracic cavity is superimposing the ____________ border
- superior scapular angle is seen __________ clavicle superimposition -humeral shaft demos ____ degrees of abduction -scapula seen without longitudinal foreshortening -superior scapular angle is slightly (.25") ___________ to the clavicle - superimposed lateral//vetebral without 90 inferior AP SCAPULA - with less than ____ degrees of humeral abduction, the inferolateral border of the scapula is ________________ by the thoracic cavity and the clavicle is ___________________ over the superior scapular angle - 60 superimposed superimposed AP SCAPULA- if the patients arm isn't sufficiently abducted and the shoulder retracted, the scapular body demos excessive ___________________ and the glenoid cavity is demonstrated somewhat on _____ - foreshortening end AP SCAPULAR PROJECTION that the arm adequately abducted when the superior angle is more or less than .25 inch inferior to the clavicle. -
AP SCAPULA- when the superior scapular angle is demonstrated less than .25 inch from the clavicle, the upper midcoronal plane was tilted _________________ - anteriorly AP SCAPULA- when the superior scapular angle appears more than .25 inch inferior to the clavicle, the upper midcoronal plane was tilted _______________ - posteriorly LATERAL SCAPULA IMAGE ANALYSIS GUIDELINES-
