Shoulder position survey

MissE · Moderator Joined: 29 Jun 2006 Posts: 156 Location: Ohio

I would like to know how many students and techs prefer to radiograph the lateral scapula (the 'Y') projection in an AP or PA. (This is the projection not the position of the body). If you have any thoughts on this please give your opinion also. Thanks!

xrayquilter · Power User Joined: 04 Jul 2006 Posts: 120 Location: Ohio

Now, I'm just learning to do shoulders, but I seem to have a phobia about them~~ they scare me to death!! Don't know why, I'm just terribly uncomfortable with them. Confused

I know that means I need to do more of them~~LOTS more! I guess I prefer the PA projection because that is what I was taught. The techs where I am doing my clinicals seem to prefer the AP projection, but that is the way they were taught

NAT · Posted: Sun Jul 16, 2006 12:59 pm Post subject:

I've been doing my lateral Y's AP. What I've been doing is this...

If the affected side is their right shoulder, I'll have the patient reach with their right hand and grab their left mid humerus. Doing this will bring their right scapula into an almost perfect lateral position. I'll then have the patient turn ever so slightly away from the affected side. I always use manual technique, usually 70 to 77kVp @ 20 to 25 mAs.

Funny thing is, I have yet to have any real problems ensuring that I get the anatomy demonstrated laterally, but I'll occasionally center to low, clipping the superior aspect of the scapula. Such are the travails of a 1st-year student!

MissE · Moderator Joined: 29 Jun 2006 Posts: 156 Location: Ohio

NAT · Posted: Sat Jul 22, 2006 8:06 am Post subject:

MissE,

I center right at the lower aspect of the deltoid muscle.

But think of it this way... orient the cassette portrait and ensure the top of the shoulder's shadow is seen on the wall bucky. This way, you'll get the top & bottom of the scapula.

MissE · Moderator Joined: 29 Jun 2006 Posts: 156 Location: Ohio

Thank-you very much NAT. Wink

ImLookingThruU · Joined: 13 Aug 2006 Posts: 16 Location: Oregon

One of the techs at my extern site insists on doing the supraspinatus (Neer method) and trauma Y-views PA, using a cone. I've found that it is much easier to position someone this way. All you have to do is make sure the area of interest is within the circle of the light field, and leave a tiny tiny crescent of light showing at the superolateral edge of the shoulder. You'll get it every time.
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Radiographers do it in over 400 positions.