humerus

Question 1

• Supinate hand.
• Humeral epicondyles
  parallel with plane of
  film.
• Both epicondyles seen
  in profile.
• Best demonstrate the
  Greater tubercle in
  profile

Answer 1

HUMERUS AP

Question 2

• Best demonstrate the
  lesser tubercle in
  profile.
• Epicondylar line
  perpendicular to the film.
• confirmed by the
  superimposed
  epicondyles.

Answer 2

HUMERUS LATERAL

Question 3

• Place affected arm in
  neutral rotation and drop
  shoulder if possible.
• Raise unaffected arm and
  place over the top of the
  head.

Answer 3

TRANSTHORACIC LATERAL PROJECTION
LAWRENCE METHOD

Question 4

• Medial and lateral
  epicondyles at a 45
  degrees angle to plane
  of cassette.
• Greater tubercle
  partially superimposed
  the humeral head
• Humeral head in partial
  profile.
• Best demonstrate the
  posterior part of the
  supraspinatus
  insertion.
• Oblique view of the
  proximal humerus.

Answer 4

SHOULDER JOINT
AP PROJECTION
NEUTRAL ROTATION

Question 5

• Medially (internally)
  rotate palm of hand
  (thumb side down).
• Back of the hand
  against thigh/hip.
• Best demonstrate the
  lesser tubercle in
  profile medially.
• Profile image of the site
  of the supraspinatus
  tendon.
• Lateral view of the
  humerus.

Answer 5

SHOULDER JOINT
AP PROJECTION
INTERNAL ROTATION

Question 6

• Laterally (Externally)
  rotate palm of the hand
  (extreme supination)
• Best demonstrate the
  greater tubercle in
  profile on the lateral
  aspect of the humerus
• The true AP projection
  of the humerus in the
  anatomic position.
• Profile image of site of
  insertion of the
  supraspinatus tendon.

Answer 6

SHOULER
AP PROJECTION
EXTERNAL ROTATION

Question 7

• Patient in supine
  position
• Abduct arm of the
  affected side 90°
• Humerus in external
  rotation with the palm
  up.
• Horizontally through
  the axilla to the
  acromioclavicular joint.
• 15°-30° if abduction of
  arm is less than 90°
• Best demonstrate the
  lesser tubercle in
  profile directed
  anteriorly
• Demonstrate an
  inferosuperior axial image
  of the proximal humerus.

Answer 7

INFEROSUPERIOR AXIAL PROJECTION LAWRENCE METHOD

Question 8

• Demonstrate an
  inferosuperior axial image
  of the proximal humerus.
• Best demonstrate the
  lesser tubercle in profile
  directed anteriorly
• Demonstrate Hill-Sachs
  defect - Compression
  fracture of the articular
  surface of the humeral
  head with anterior
  dislocation of the
  humeral head.

Answer 8

RAFERT MODIFICATION

Question 9

• Abduct arm of the
  affected side 90°
• 25° anteriorly from the
  horizontal and 25°
  medially and enters 5
  inches (13 cm.) and 1 ½
  medial to the acromial
  edge and exits the glenoid
  cavity.
• Humeral head projected
  free of coracoid
  process.

Answer 9

WEST POINT METHOD

Question 10

• Patient in lateral
  recumbent position
  lying on the unaffected
  side.
• Lesser tubercle in
  profile

Answer 10

INFEROSUPERIOR AXIAL PROJECTION
CLEMENTS MODIFICATION

Question 12

• Abduct arm slightly
  with arm in neutral
  position
• Glenoid cavity in profile
  without superimposition
  of the humeral head.
• Rotate the body 35°-45°
  toward the affected
  side

Answer 12

GRASHEY METHOD

Question 13

• Rotate unaffected side
  away from the IR 45°-60°
  from the plane of the
  film.
• CR 10°-15° caudad
  entering the superior
  aspect of the humeral
  head.

Answer 13

NEER METHOD

Question 14

Flex the arm slightly
beyond 90°
* 10° cephalad entering the
coracoid process.
* Demonstrate the
posterosuperior and
posterolateral areas of
the humeral head.

Answer 14

STRYKER NOTCH METHOD

Question 15

• Rotate the body 35°-45°
  toward the affected
  side.
• Abduct the arm 90°
  from the midline of the
  body holding a 1 pound
  weight on the affected
  side.
• Glenoid cavity in profile
• Demonstrate loss of
  articular cartilage in the
  scapulohumeral joint
  but uses a weighted
  abduction.
• Similar to the Grashey
  method except for the
  use of the 1 pound
  weight.

Answer 15

APPLE METHOD

Question 16

• Rotate the body 45°
  towards the affected side.
• CR 45° caudad through
  the scapulohumeral joint.
• Demonstrate any posterior
  scapulohumeral
  dislocations.
• Recommended projection
  for acute shoulder
  trauma.

Answer 16

GARTH METHOD

Question 17

Patient in supine, seated or
upright position
* Hand in supination
* CR 10-15° posterior to the
long axis of the humerus.
FISK
* Patient standing at the edge

Answer 17

FISK MODIFICATION

Question 18

• Patient in upright
  position
• SID -72 INCHES,include
  both joints,reduces
  distortion of the joint
• Upright without weights
• Upright with equal
  weights (5-8 lb) affixed to
  each wrist
• This projection is used
  to demonstrate AC joint
  disclocation, separation
  and function of the
  joints.

Answer 18

PEARSON METHOD

Question 19

• Patient in upright position
• Demonstrate the AC Joint
  projected slightly
  superiorly compared with
  an AP projection.
• 15° cephalic to the
  coracoid process (this
  angulation projects the
  AC joint above the
  acromion).

Answer 19

ALEXANDER METHOD