Radiographic Positioning: Radiographic Positioning of the Shoulder

NON-TRAUMA SHOULDER

ROUTINE POSITIONS (non-trauma):
AP External
AP Internal Rotation

ADDITIONAL VIEW:
True AP

AP External
1. 10 x 12 crosswise
2. Patient supine or standing
3. Rotate arm externally (palm up)
4. Bucky
5. 40" SID
6. Central Ray: perpendicular to film, centered to coracoid process.
7. Expiration

AP Internal Rotation
Position same as external except have patient rotate arm internally (pronate hand).

ADDITIONAL VIEW
*If joint is not open on AP external or AP internal. Must include this view*

True AP (Glenohumeral Joint Space)
1. 10 x 12 crosswise
2. Patient supine or upright
3. Rotate body approximately 35o toward side of interest, posterior aspect of arm and shoulder should be in contact with table.
4. Bucky
5. 40" SID
6. Expiration

ROUTINE POSITIONS (trauma):
"Y" view
True AP
AP Neutral

ADDITIONAL VIEW:
Axillary

"Y" View
1. 10 x 12 lengthwise
2. Patient supine or upright
3. Palpate the borders of the scapula and rotate the patient until the scapula is in true lateral position.
4. Bucky
5. 40" SID
6. Central Ray: direct to midvertebral border of scapula, film placed 2 inches above shoulder.
7. Used to demonstrate dislocation
8. Expiration

True AP
1. 10 x 12 crosswise
2. Patient supine or upright
3. Rotate body approximately 35o toward side of interest, posterior aspect of arm and shoulder should be in contact with table.
4. Bucky
5. 40" SID
6. Expiration

AP Neutral
1. 10 x 12 crosswise
2. Patient supine or standing
3. Do not rotate patient's arm
4. Bucky
5. 40" SID
6. Central Ray: perpendicular to film, center to coracoid process
7. Expiration

ADDITIONAL VIEW
*Done only after routine trauma series completed and checked with ordering physician*

Axillary (transaxillary lateral)
1. 8 x 10 crosswise
2. Patient supine
3. Ordering physician or his designee must abduct patient's arm 90o from body.
Place support under patient's wrist and hand if needed.
4. Rotate patient's head from affected side. Rest film holder on table surface as close to neck as possible.
5. Table top
6. 40" SID
7. Central Ray: horizontally to axilla