Radiography of Humerus with the patient in lying position (Trauma) AP Lateral Projection

Tuesday, May 22, 2018

AP Projection - Recumbent

The image receptor size should be long enough to include the entire humerus.

Image receptor: Lenghtwise 18 X 43 cm

Patient Position:

With the patient in supine position, adjust the image receptor to include the entire length of the humerus.

Part Position:

  • Place the upper margin of the image receptor approximately 1.5 inches above the humeral head.
  • Elevate the opposite shoulder on a sandbag to place the affected arm in contact with the image receptor or elevate the arm and image receptor on sandbags.
  • Unless contraindicated, supinate the hand and adjust the limb to place the epicondyles parallel with the plane of the image receptor.

Shield gonads

Respiration: suspended

Central Ray:

Perpendicular to the mid portion of the humerus and the center of the image receptor.

Lateral Projection - Lateromedial Recumbent

Patient Position:

Place the patient in the supine position with the humerus centered to the image receptor, or use a bucky tray.

Part Position:

  • Adjust the top of the image receptor to be approximately 1.5 inches above the level of the head of the humerus.
  • Unless contraindicated by the possible fracture, abduct the arm somewhat and center the image receptor under it.
  • Rotate the forearm medially to place the epicondyles perpendicular to the plane of the image receptor, and rest the posterior aspect of the hand against the patient’s side. This movement turns the epicondyles in the lateral position without flexing the elbow. (the elbow maybe flexed slightly for comfort)
  • Adjust the position of the image receptor to include the entire length of the humerus.

Lateral Projection – Lateromedial

Recumbent or Lateral Recumbent Position

  • When a known or suspected fracture exists, position the patient in the recumbent of lateral recumbent position, place the image receptor close to axilla and center the humerus to the image receptor’s midline.
  • Unless contraindicated, flex the elbow, turn the thumb surface of the hand up, and rest the humerus on a suitable support.
  • Adjust the position of the body to place the lateral surface of the humerus perpendicular to the central ray.
  • Shield gonads
  • Respiration: suspend

Central ray Recumbent Position:

The central ray is horizontal and perpendicular to the midportion of the humerus and the center of the image receptor.

Central ray Lateral Recumbent:

Directed to the center of the image receptor, which exposes only the distal humerus.

Structure shown:

The lateral projection demonstrate the distal humerus.

a. healing fracture b. comminuted fracture

Evaluation Criteria:

The following should be clearly clearly demonstrated:
  • Distal humerus
  • Superimposed epicondyles

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