- An optimal trauma projection for possible scapulohumeral dislocations (especially posterior dislocation), glenoid fractures, Hill-Sachs lesions, and soft tissue calcifications.
- IR size - 18 x 24 cm (8 x 10 inches), lengthwise
- Moving or stationary grid
- Digital IR - very close collimation required
- 75 +- 5 kV range
- mAs 12
|Erect apical oblique axial projection - 45 degrees posterior oblique|
CR 45 degree caudad
- Shield pelvic area.
- Perform radiograph with the patient in an erect or supine position. (The erect position is usually less painful, if patient's condition allows.) Rotate body 45 degree toward affected side ( posterior surface of affected shoulder against IR.)
- Center scapulohumeral joint to CR and mid-IR.
- Adjust IR so that the 45 degree angled CR will project the scapulohumeral joint to the center of the IR.
- Flex elbow and place arm across chest, or with trauma, place arm at side as is.
- CR 45 degree caudad, centered to the scapulohumeral joint.
- Minimum SID of 40 inches (100 cm)
- Collimate closely to area of interest.
- Suspend respiration during exposure.
|AP axial oblique: Garth method demonstrates an antrior dislocation of the|
proximal humerus. The humeral head is shown below the coracoid process,
a common appearance with anterior dislocation
- The humeral head, glenoid cavity, and neck and head of the scapula are well demonstrated free of superimposition.
- The coracoid process is projected over part of the humeral head, which appears elongated.
- The acromion and AC joint are projected superior to the humeral head.
Collimation and CR:
- Collimation should be visible on four sides to area of affected shoulder.
- CR and center of collimation field should be at the scapulohumeral joint.
- Optimal density and contrast with no motion will demonstrate clear, sharp bony trabecular markings and soft tissue detail for possible calcifications.