![]() If the patient leans back into the cassette, adopting a lordotic stance, then the head of humerus will overlie the acromion process. ![]() The image appearance is affected significantly by the posture of the patient. To judge the degree of rotation of the humerus by the position of the hand can be very misleading. When the line joining the epicondyles is parallel to the tabletop (or vertical cassette), the humerus is in position for an antero-posterior projection of the head of the humerus. When examining the shoulder joint, it is important to check on the position of the head of the humerus by palpating and positioning the epicondyles at the distal end of the humerus. To improve radiographic contrast, a secondary radiation grid can be used for large patients however, the increased contrast resolution of a computed radiography (CR) imaging system reduces the need for this. tendon calcifications or joint spaces, the X-ray beam should be well collimated. When localized areas are being examined, however, e.g. for injury, the field size must be large enough to cover the whole of the shoulder girdle on the injured side. The central ray can be directed caudally after centring to the coracoid process so that the primary beam can be collimated to the area under examination.įor a general survey of the shoulder, e.g. The erect position affords ease of positioning, allows the head of humerus to be assessed more accurately for potential impingement syndrome, and can sometimes demonstrate a lipohaemarthrosis where there is a subtle intra-articular fracture.įor radiation protection, particularly of the eyes, the patient's head should be rotated away from the side being examined. Radiographic examinations of the shoulder joint and shoulder girdle can be carried out with the patient supine on the X-ray table or trolley, but in most cases it will be more comfortable for the patient to sit or stand with the back of the shoulder in contact with the cassette.
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