INFEROSUPERIOR AXIAL PROJECTION: SHOULDER (NON TRAUMA)

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.

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).

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.