2 Shoulder Girdle
SHOULDER JOINT
Points to consider
Technique
An axial projection of the shoulder may be required
Exposure on arrested respiration
Never forcibly abduct the humerus
#ed clavicle – do not rotate patient – foreshortens the clavicle
Lateral transthoracic – do not attempt because it increases radiation dose
Radiological assessment
Anterior dislocation – humeral head below coracoid process
Posterior dislocation – rare (about 5% of cases) – often overlooked, remember ‘light bulb sign’
Common site of # – surgical neck of humerus
Check for impaction – # may be overlooked
Acute inflammation – look for calcification – rotator cuff muscles
AP shoulder girdle
This projection gives a general assessment of the shoulder girdle
• Patient may be supine or erect facing the X-ray tube
• Body is very slightly rotated onto the affected side
SHOULDER JOINT
Projection: AXIAL SUPEROINFERIOR
Centring Point: To the acromion process with 10° angulation away from the body
Points to consider
Technique
Superoinferior – only use when full abduction is possible
Must include the glenohumeral joint on the radiograph
Inferosuperior – when only limited abduction possible
Axial projection should be taken in all cases of trauma
Acute injury – never forcibly abduct the arm
Radiological assessment
