SUPEROINFERIOR - TRANSAXILLARY ( PA VIEW ) : SHOULDER

Monday, March 9, 2015

MODIFICATION OF HOBBS METHOD
SUPEROINFERIOR PA TRANSAXILLARY PROJECTION


Warning:
  • Do not attempt to rotate, force extention, or abduct arm if fracture or dislocation is suspected.

Pathology Demonstrate:
  • Fracture and/ or dislocation of the proximal humerus are shown. Bursitis, shoulder impringement, osteoporosis, osteoarthritis, and tensonitis may be demonstrated.

Technical Factor:
  • IR size - 18 x 24 cm (8 x 10 inches) lengthwise
  • Bucky or stationary grid (CR to centerline of grid)
  • 70 +- 5 kV range
  • mAs 7

Shielding:
  • Place lead shield over pelvis and radiosensitive regions.

Patient Position:

  • Tale radiograph with the patient in an erect position or by leaning the patient over the end of the x-ray table. The patient is positioned in a slight 5 to 10 degree anterior oblique.

Part Position:

  • The arm is raised superiorly as much as the patient can tolerate.
  • The head is turned away from the affected arm.

Central Ray for Hobbs Modification:


  • CR is directed perpendicular to the axilla and teh humeral head to pass through the glenohumeral joint.
  • Minimum SID is 40 inches (100cm)

Collimation:


  • Collimate closely on four sides.

Respiration:


  • Suspend respiration during exposure.


RADIOGRAPHIC CRITERIA OF HOBBS MODIFICATION:

Structure Shown:
  • Lateral view of proximal humerus in relationship to the glenohumeral articulation is visualized.
  • Coracoid process of scapula is seen on end.

Position:
  • Arm is seen to be raised superiorly above the body.

Collimation and CR:
  • 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.

Superoinferior PA Transaxillary Projection Exposure Criteria:
  • Optimal density and contrast with no motion will demonstrate clear, sharp bony trabecular markings.
  • The body margins of the acromion and coracoid process will be visible through the humeral head.

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