It contains clear explanations with photographs of all commonly performed xray exams and is essentially a condensed version of the positioning portions of bontragers popular textbook of radiographic positioning and related anatomy, now in its 4th edition as published by mosby, inc. The clavicle is the most proximal bone of the upper limb, and provides leverage and support for the shoulder girdle structures. Xrays and other imaging are one of the big four in diagnosing shoulder and elbow problems the four being hx, sst, pe, and xrayfilms. Does my clavicle bone needs surgery based on my xray. A bone that lies horizontally and connects the shoulder and arm to. Rad 103 positioning of the clavicle and scapula flashcards. The radiographic series of the clavicle is utilized in emergency departments to assess the clavicle, acromioclavicular and sternoclavicular joint. In this quiz on human anatomy, well be focusing in on the shoulder, clavicle, scapula ac joints and their respective positions in the body. Erect or leaning over the end of the xray table, in a slight 510 degree anterior oblique. The bottom of the acromion should align with the bottom of the distal clavicle fig.
Measurement of clavicle fracture shortening using computed. Radiographic positioning of the upper limb guide apps. It is often utilized in the context of trauma to rule out fractures and dislocations. Now in its second edition, pocket atlas of radiographic positioning is a practical howto guide that provides the detailed information you need to reproducibly obtain highquality radiographic images for optimal evaluation and interpretation of normal, abnormal, and pathological anatomic findings. In ap central ray is zero, while in axial varies depending on patients habitus. Hearon clavicle imaging advanced orthopedic associates. Notably, their study utilized only healed clavicle fractures with varying degrees of shortened malunion.
Note the differences between the ap and pa chest films below. An xray examination demonstrating the clavicle in ap and ap axial view. Merrills atlas of radiographic positions and radiologic procedures, volume 1 merrills atlas of radiographic positions and radiologic procedures, merrills atlas of radiographic positions and radiologic procedures, isbn 0801679354, 9780801679353. See more ideas about radiology, medical radiography and rad tech.
Upper limb radiographic positioning upper limb radiography is the radiological investigation of the shoulder girdle, humerus, ulna, radius, carpals and metacarpals of the hand. Complications can include a collection of air in the pleural space surrounding the lung pneumothorax, injury to the nerves or blood vessels in the area, and an unpleasant appearance. The experienced author team appreciates that there is no substitute for a good understanding of basic skills in patient positioning and an accurate knowledge of anatomy to ensure good radiographic practice. Bontragers handbook of radiographic positioning and. The joint is located in the spot where the clavicle collarbone meets the sternum breastbone at the base of the neck. Critique this radiograph using the trauma ap shoulder criteria as your guide. Radiography of the clavicle is commonly performed in order to confirm the provisional diagnosis of fracture and is also used to help outline possible treatment options following injury of the clavicle. Positioning for the mta shoulder projection with the supine patient.
All patients need to have a current xray for evaluation purposes. Thin asthenic patient 10 to 15 but more angulation is required with thicker patients. Shoulder, clavicle, scapula, ac joints positioning. It is often caused by a fall onto an outstretched upper extremity, a fall onto a shoulder, or a direct blow to the clavicle. Patient erect or supine with arms at sides, chin raised, looking straight ahead. Voltage of the xray beam should be reduced by 50% relative to.
Sternoclavicular sc joint disorders orthoinfo aaos. When a request is made to take a shoulder xray the radiograph should. Position same as ap except tube is angles 1020 degree cephalad. Clarks pocket handbook for radiographers slideshare. The xray beam was focused on the center of the clavicle in all radiographs. Brent burbridge md, frcpc, university medical imaging consultants, college of medicine, university of saskatchewan is used under a ccbyncsa 4. Additionally, the image can provide information on the position of the shoulder joint. Positioning chapters organized with one projection per page to present a snapshot of information in an easily accessible and portable format unique page layout positioning photos and radiographic images are presented on the same page with the text explanation of each procedure to show you how the patient should be positioned and what the image should look like. Ap with the humerus in neutral position or with the humerus in internal andor without. Many research projects are underway regarding the medical healing process of clavicle fractures. This places the clavicle closer to the ir improving recorded detail. The incidence of clavicle fractures in adolescent and adult population is suggested to be between 29 and 64 per 100.
The radiographic series of the clavicle is utilized in emergency departments. The patients sits facing the x ray tube with the cassette placed cassette holder. State the proper positioning of the humerus for the ap views of the shoulder and tell what. The ap view results in the magnification of anterior structures such as the clavicle, sternum, and heart, that can. Optimizing the radiographic technique in clavicular fractures. Clavicle xrays are indicated for a variety of settings including. An xray of the clavicle bone, or collar bone, is a radiographic image of the clavicle, which connects the arm to the body. Trauma xray upper limb clavicle radiology masterclass. The clavicle, also known as the collar bone, is the only bone connecting the pectoral girdle to the axial skeleton and is the only long bone that lies horizontally in human skeleton. Fracture and dislocation of clavicle can be studied in this view. Learn vocabulary, terms, and more with flashcards, games, and other study tools. If these are enlarged sometimes a soft tissue show may be evident on chest radiograph. Xray cassette is behind the patient parallel to thorax. Clinically, injuries to the shoulder may include the entire clavicle sternoclavicular separation, scapulothoracic dislocation.
Ap front to back picture lateral sidetoside picture. Posterior surface of shoulder should be in contact with cassette or tabletop, without rotation of body last anterior routine. Patients with mris only, outside films and out dated xrays taken here more than 6 months need new films done by our techs. An examination of practice during radiography of the clavicle. A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. Bontragers handbook of radiographic positioning and techniques, 9th edition provides bulleted instructions, along with photos of properly positioned patients, to help you safely and confidently position for the mostcommonly requested radiographic studies. Ce4rt radiographic positioning of the elbow for xray. Clavicle ap cephalic view radiology reference article. The book presents the essentials of radiographic techniques in a practical way, avoiding unnecessary technical complexity and ensuring that the student and practitioner can find quickly the information that they require regarding particular positions. Clavicle fracture academic dictionaries and encyclopedias. If rad 112l is dropped then rad 112 must be dropped. Clavicle fractures result in inferior displacement of the distal component. This article discusses radiographic positioning for radiologic technologists xray techs to show the forearm and elbow. Center clavicle to center of cassette considering cephalic cr angle c.
This does not imply protocol standards for all radiology facilities. Start studying rad 103 positioning of the clavicle and scapula. The appearance of the chest film is affected by the ap positioning, supine positioning, and the degree of inspiration. First published in 1939, this is the definitive text on patient positioning for the diagnostic radiography student and practitioner. Clavicle fracture undergraduate diagnostic imaging fundamentals. Sternoclavicular sc joint disorders the sternoclavicular sc joint is one of the four joints that complete the shoulder. Often used in conjunction with the ap clavicle, this projection straightens out the clavicle and projects it above overlaying anatomy. A clavicle fracture, or the more familiar broken collarbone, is a common injury that with appropriate treatment usually heals completely, allowing you to resume normal activity. Ahmad explains how to work with a patient in the supine or upright position, as well as the differences between the. Suggested techniques and critique points offer a quick reference for evaluating your own radiographs, making it an invaluable tool for learning radiographic positioning in clinical settings.
This class must be taken concurrently with rad 112l. Digital xray articles proper positioning for the pelvis and proximal femur the lowdown on lumbar spine positioning radiographic positioning techniques for the cervical spine boning up on humerus, clavicle, and ac joint positioning getting the most from shoulder positioning the bends and flexures of forearm and elbow xray positioning. Clavicle complete 73000 scapula complete 73010 toes minimum 2 views 73660 foot 2 views 73620. Some holders allow 15 degrees angulation towards the shoulder. The authors recommend the implementation of pa positioning for clavicle radiography. Acromioclavicular joints separation is demonstrated. Purpose and structures shown this view should demonstrate the radius and ulna and soft tissue of the forearm position of patient the patient should be seated sideways at the end of the the table. Central ray directed from behind the patient to the clavicle. How much do you know about the way your body operates. The following points may be used as a guide to assess shoulder xrays. This ordering guide is meant to assist you when ordering a study with radiology ltd. Shoulder, including clavicle and scapula radiology key.
Radiography of the acutely injured shoulder radiography. Xray beam directed anterior to posterior, perpendicular to cassette or angled 10degrees cephalad and centered at the coracoid. Lymph nodes reside superior and inferior to clavicle. Considering that you dont get operated, still permanent disability is minimal with this fracture even if bone doesnt heal.
The anatomy of the shoulder includes only the distal clavicle, the glenohumeral joint, and the proximal humerus, which governs positioning for the radiographic examination of the shoulder. A clavicle fracture is a bone fracture in the clavicle, or collarbone. Ultrasound or ct would be much more accurate in identifying enlarged lymph nodes. Symptoms typically include pain at the site of the break and a decreased ability to move the affected arm. Radiographic positioning comprehensive and concise. This course requires student to student, or instructor to student physical contact. The central ray is at right angles to the coronal plane of the clavicle. This reduces the distortion caused by the cranial angulation. Routine radiographic projections for imaging of the acute shoulder include the ap with an additional projection. Naveed ahmad breaks down the basic components of xray imaging of the humerus.
Ac joints alexander method alternative bilateral with and without weights warning. How to read a chest xray a step by step approach dr. Shoulder andor clavicle projection should be completed first to rule out fracture, or this radiograph may be taken without weights first and check before it is taken with weights pathology demonstrated in ap ac joints. Clavicle radiography is frequently performed with the patient in the ap erect position as shown in this illustration. A method to demonstrate the clavicle projected above the thoracic cage. Position patient is erect with arms relaxed and hanging freely at the side. Positioning the entire clavicle medial end of clavicle is seen next to the lateral vertebral column the humeral head should overlap the glenohumeral joint this occurs more with internal rotation compared to external or neutral position of. This 12th edition retains the books preeminence in. The clavicle ap cephalic angulation view is a standard projection part of the clavicle series. In addition to covering anteroposterior and lateral radiographs, dr. This 12th edition retains the book s preeminence in the field, with hundreds of positioning photographs and explanatory line diagrams, a clearly defined and easytofollow structure, and international applicability.