Rotational Lateral Humerus

Tuesday, June 6, 2017

Warning: When performing this position to trauma patient do not attempt to rotate arm if fracture or dislocation is suspected.

Film Size: 35 x 43 cm lengthwise or 30 x 35 cm lengthwise
Use Grid if anatomy is greater than 10cm, and Image Receptor only if less than 10cm in thickness.
Central Ray: CR is perpendicular to midhumerus
SID: 40 – 44 inches
Collimation: Collimate on sides to soft tissue borders of humerus and shoulder.

Patient Positioning:

This projection may be taken Erect AP or PA, or the patient is supine.

Erect (PA) Position: Flex elbow into 90 degrees and patient is rotated 15 – 20 degrees from PA or as needed to bring humerus and shoulder in contact with Image Receptor holder. The epicondyle is perpendicular to IR for a true lateral projection.

Rotational lateral humerus
Erect Lateral PA Humerus

Erect or Supine Position AP: Elbow slightly flexed, arm and wrist rotated for lateral position, this will bring palm backwards. The epicondyles is perpendicular to image receptor.
Image receptor is centered to anatomy of interest to include both elbow and shoulder joints.

Rotational lateral humerus
Rotational Lateral Erect AP

Supine Rotational AP Humerus

Evaluation Criteria:

Anatomy Demonstrated: AP and lateral projection should include the entire humerus, including elbow and glenohumeral joints.

AP Projection Criteria:

  • No rotation of medial and lateral epicondyles seen in profile, greater tubercle in profile laterally.
  • Humeral head and glenoid cavity are demonstrated on the film.

Lateral Projection PA: True lateral, epicondyle are directly superimposed.

humerus xray
AP Rotational Lateral and True Lateral Humerus

Exposure Criteria:

  • Optimal density and contrast resolution on the image.
  • Sharp bony trabeculation should be clearly demonstrated with no motion artifact.

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