INFEROSUPERIOR AXIAL SHOULDER X-RAY

Saturday, March 8, 2014

 

INFEROSUPERIOR AXIAL PROJECTION: SHOULDER

| WEST POINT METHOD

Stucture Shown:

  • The resulting image shows bony abnormalities of the anterior inferior rim of the glenoid in patient with instability of the shoulder.

Technical Factor:

  • IR size - 18 x 24 cm (8 x 10 inches), crosswise placed in contact with the superior surface of the shoulder
  • 70 +- 5 kV range
  • mAs 10

Shielding:

  • Place lead shield over pelvis and radiosensitivity regions.

west point method
Inferosuperior axial shoulder joint: West Point method

Patient Position:

  • Adjust the patient in the prone position with approximately a 3 inches ( 7.6 cm ) pad under the shoulder being examined.
  • Turn the patient's head away from the side being examined.

Part Position:

  • Abduct the arm of the affected side 90 degrees, and rotate so that the forearm rest over the edge of the table or a bucky tray, which may be used for support.
  • Place a vertically supported IR against the superior aspect of the shoulder with the edge of the IR in contact with the neck.
  • Support the IR with sandbags or a vertical IR holder

West Point method with anterior and medial central ray angulation

Central Ray:

  • Directed at a dual of 25 degrees anteriorly from the horizontal and 25 degrees medially.
  • The CR enters approximately 5 inches (13 cm) inferior and 1 1/2 inch (3.8 cm) medial to the acromial edge and exits the glenoid cavity.

Collimation:

  • Collimate closely on four sides.

Respiration:

  • Suspend respiration during exposure.


RADIOGRAPHIC CRITERIA ON WEST POINT METHOD


Structure Shown:

radiograph west point method
  • Humeral head projected free of the coracoid process
  • Articular between the head of the humerus and the glenoid cavity
  • Acromion superimposed over the posterior portion of the humeral head
  • Shoulder joint
  • Collimation should be visible on four sides to the affected shoulder.

Exposure Criteria:


  • Optimal density and contrast with no motion will demonstrate clear, sharp bony trabecualr markings.
  • The bony margins of the acromion and coracoid process will be visible through the humeral head.

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