INFEROSUPERIOR AXIAL PROJECTION: SHOULDER (NON TRAUMA)

Monday, December 1, 2014

CLEMENTS MODIFICATION

Warining:
  • Do NOT attemp to rotate arm or force abduction if fracture or dislocation is suspected.

Pathology Demonstrated:
  • Osteoporosis, Osteoarthritis, and the HillSachs defect may be demonstrated.

Technical Factor:
  • IR size - 18 x 24 cm (8 x 10 inches), lengthwise
  • 70 +- 5 kV range
  • mAs 10

Shielding:
  • Place lead shield over pelvis and radiosensitive regions.
Arm abducted 90 degrees

Patient Position:
  • Position patient in the lateral recumbent position with the affected arm up.

Part Position:
  • Abduct arm 90degrees from body if possible.

Central Ray:
  • Direct horizontal CR perpendicular to the IR.
  • If the patient cannot abduct the arm 90 degrees, then angle the tube 5 - 15 degrees toward the axilla.
  • Minimum SID is 40 inches (100cm).
Arm partially abducted.

Collimation:
  • Collimate closely on four sides.

Respiration:
  • Suspend respiration during exposure.

Radiographic Criteria:

Stucture Shown:
  • Lateral view of proximal humerus in relationship to the scapulohumeral cavity is shown.

Position:
  • Arm is seen to be abducted about 90degrees from the body.
  • The relationship of the humeral head and glenoid cavity should be evident.

Collimation and CR:
Inferosuperior axial shoulder joint: Clements modification.
  • Collimation should be visible on four sides to the affected shoulder.
  • CR and center of collimation field should be at the axilla and humeral head.

Exposure Criteria:
  • Optimal density and contrast with no motion will demonstrate clear, sharp bony trabecular markings.
  • The bony margins of the acromion and distal clavicle will be visible through the humeral head.

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