Scapula : Lateral Projection

Tuesday, March 11, 2014

Xray of the Scapula : Lateral View

Lateral of view of the scapula can be done in Left Posterior Oblique (LPO) or Right Posterior Oblique (RPO). In this projection fracture of the scapula is demonstrated. This projection results in magnified image because of increased OID.

Technical Factors and Patient Shielding:

IR size - 24 x 30 cm ( 10 x 12 inches), lengthwise
Moving or stationary grid
Manual exposure factors (AEC is not recommended)
Digital IR - requires very close collimation
75 +- 5 kV range
Place lead shield over pelvic area.

Patient Position when Performing Lateral Scapula:

Perform radiograph with the patient in a supine position, and place affected arm across chest. Then rotate entire body approximately 30 degrees or as needed to elevate affected shoulder until body of scapula is in a true lateral position. Flex knee of affected side to help patient maintain this oblique body position.

Part Position, Central Ray and Collimation:

Palpate borders of scapula by grasping medial and lateral borders of body of scapula with fingers and thumb.
Carefully adjust body rotation as needed to bring the plane of the scapula body perpendicular to the IR.
Align patient on tabletop so that the center of the midlateral (axillary) border of scapula is centered to the CR and IR.
CR to midscapula lateral border
Minimum of 40 inches (100 cm) SID.
Collimate to area of scapula.

Breathing Technique:

Respiration must be Suspend during exposure on lateral scapula to possible elimination of blurring that is cause by patient motion.
Radiographic Criteria:

Structure Shown and Patient Positions:

Entire scapula should be visualized in a lateral position.
True lateral is shown by direct superimposition of vertebral and lateral borders.
Body of scapula should be seen in profile, free of superimposition by ribs.
As much as possible, the humerus should not superimposed area of interest of the scapula.

Collimation and Central Ray:

Collimation should be visualized on four sides to area of scapula.
CR and center of collimation field to lateral border of midscapula.

Exposure Criteria:

Optimal exposure with no motion will demonstrate sharp bony borders and trabecular markings.
Entire scapula should be visualized without excessive density in area of inferior angle.
Bony borders of both the acromion and coracoid processes should be seen through the head of the humerus.

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