Elbow AP
4
Feb

Overview

The AP elbow radiograph evaluates the distal humerus proximal radius and ulna. The patient extends the elbow with the palm up to obtain a true AP projection. This view is essential for detecting fractures and joint effusion.

Technique

Center the detector to the elbow joint and ensure the humeral epicondyles are parallel to the detector. Use appropriate exposure and immobilize the limb to reduce motion. Include the distal humerus and proximal forearm in the field.

Clinical Indications

AP elbow is indicated for trauma pain and limited range of motion. It helps detect supracondylar fractures radial head injuries and joint effusions. Additional lateral and oblique views complement the AP projection.

Image Assessment

Assess cortical continuity and joint alignment and look for fat pad signs indicating occult fracture. Evaluate the radial head neck and coronoid process for injury. Correlate with clinical findings and consider CT for complex fractures.

Axillary Shoulder View
4
Feb

Overview

The axillary shoulder view visualizes the glenohumeral joint from an inferior superior perspective. It is valuable for detecting dislocation and assessing joint congruity. The view requires patient cooperation and appropriate arm positioning.

Technique

Obtain the axillary view with the arm abducted and the detector placed superior to the shoulder. Alternative techniques such as the Velpeau or modified axillary may be used for patients unable to abduct. Ensure proper centering to include the glenoid and humeral head.

Clinical Indications

Axillary view is indicated for suspected dislocation and evaluation of glenoid fractures. It complements AP and Grashey views for comprehensive shoulder assessment. Use alternative projections when abduction is limited.

Image Assessment

Evaluate the glenohumeral joint space and humeral head position. Inspect for fractures of the glenoid rim and humeral head. Report findings that affect reduction and surgical planning.

Shoulder Scapular Y
4
Feb

Overview

The scapular Y view projects the scapula in a lateral orientation to evaluate humeral head position relative to the glenoid. It is useful for detecting anterior and posterior shoulder dislocations. The Y configuration is formed by the acromion coracoid and scapular body.

Technique

Position the patient in a true lateral with the affected shoulder centered and the arm in neutral. Align the detector to include the entire scapula and humeral head. Use breath hold to minimize motion artifact.

Clinical Indications

Scapular Y is indicated for trauma and suspected dislocation when axillary views are not possible. It helps determine direction of dislocation and associated fractures. Correlate with clinical exam and consider CT for complex injuries.

Image Assessment

Assess the relationship of the humeral head to the glenoid and acromion. Look for associated fractures of the scapula or proximal humerus. Document dislocation direction and recommend reduction or orthopedic consultation.

Shoulder Grashey AP Oblique
4
Feb

Overview

The Grashey AP oblique shoulder view aligns the glenoid en face to evaluate joint space and glenoid rim. The patient is rotated approximately 35 to 45 degrees toward the affected side. This view is valuable for assessing glenoid fractures and degenerative change.

Technique

Rotate the patient toward the affected shoulder and center the detector to the glenohumeral joint. Use a true oblique to profile the glenoid without overlap from the humeral head. Ensure consistent exposure and include the scapular neck.

Clinical Indications

Grashey view is indicated for suspected glenoid fracture instability and arthritis. It provides accurate assessment of joint space narrowing and rim defects. It complements standard AP and axillary views for comprehensive shoulder evaluation.

Image Assessment

Inspect the glenoid rim for fracture and the joint space for narrowing or osteophytes. Evaluate humeral head position and subchondral changes. Report findings relevant to surgical planning and instability assessment.

Shoulder AP Internal External
4
Feb

Overview

AP shoulder views in internal and external rotation assess the glenohumeral joint and proximal humerus. External rotation demonstrates the greater tuberosity while internal rotation profiles the lesser tuberosity. These complementary views aid in detecting fractures and dislocations.

Technique

Position the patient upright or supine with the detector centered to the shoulder. Obtain external rotation with the palm facing forward and internal rotation with the back of the hand on the hip. Use appropriate collimation to include the scapulohumeral joint.

Clinical Indications

AP shoulder views are indicated for trauma pain and suspected dislocation or fracture. They evaluate joint congruity and osseous integrity. Additional views such as Grashey or axillary may be required for detailed assessment.

Image Assessment

Assess humeral head position relative to the glenoid and inspect tuberosities for fracture. Evaluate joint space and acromioclavicular relationship. Correlate with clinical exam and consider CT for complex fractures.

AC Joints Bilateral AP
4
Feb

Overview

Bilateral AP AC joint radiographs compare joint alignment and detect separation or degenerative change. Weight bearing views with weights in the hands accentuate joint separation. Comparison with the contralateral side aids diagnosis.

Technique

Obtain AP views centered to the AC joints with and without weights as indicated. Use equal exposure and positioning for both sides to allow direct comparison. Ensure patient comfort and secure weights safely.

Clinical Indications

AC joint series are used for trauma shoulder pain and suspected separation. They evaluate joint space widening and coracoclavicular distance. Conservative or surgical management depends on degree of separation.

Image Assessment

Compare joint spaces and alignment between sides and between weighted and non weighted views. Look for associated clavicle fractures and degenerative changes. Report degree of displacement and recommend orthopedic follow up when needed.

Clavicle AP
4
Feb

Overview

AP clavicle radiographs evaluate suspected clavicular fractures and alignment. The patient is positioned upright or supine with the detector centered to the clavicle. Additional angled views may improve visualization of fracture displacement.

Technique

Center the detector to include the entire clavicle from sternoclavicular to acromioclavicular joints. Use a slight cephalad tube angle if needed to project the clavicle above the ribs. Immobilize the arm to reduce motion.

Clinical Indications

AP clavicle is indicated for trauma shoulder pain and suspected fracture. It helps determine fracture location and displacement for management decisions. Follow up radiographs monitor healing and callus formation.

Image Assessment

Evaluate cortical continuity and alignment of the clavicle segments. Assess for shortening and involvement of adjacent joints. Document fracture type and recommend orthopedic consultation when indicated.

Sternum RAO
4
Feb

Overview

The RAO sternum projects the sternum over the heart to reduce superimposition and improve visualization. The patient is rotated with the right anterior chest closest to the detector. This view is useful for suspected sternal fractures and lesions.

Technique

Rotate the patient approximately 15 to 20 degrees RAO and center the detector to the sternum. Use shallow breathing or suspended respiration to reduce motion blur. Collimate tightly to the sternum to reduce dose.

Clinical Indications

RAO sternum is indicated for trauma evaluation and persistent sternal pain. It helps detect cortical disruption and displacement. CT is used when radiographs are inconclusive or complex injury is suspected.

Image Assessment

Assess the sternal body manubrium and xiphoid for fractures and deformity. Evaluate for adjacent mediastinal widening or soft tissue swelling. Correlate with clinical findings and ECG when indicated.

Rib Oblique
4
Feb

Overview

Oblique rib views rotate the patient to project ribs away from the spine and thoracic structures. This technique improves visualization of rib contours and fracture lines. Both anterior and posterior rib segments can be assessed with targeted obliques.

Technique

Rotate the patient toward the side of interest and center the detector to the rib region. Use appropriate exposure and include the costochondral junction when indicated. Obtain both ipsilateral and contralateral obliques if necessary.

Clinical Indications

Oblique ribs are used when AP views are inconclusive or when detailed assessment of a specific rib is required. They are helpful in trauma and persistent localized pain. Correlate with clinical exam and consider CT for complex injuries.

Image Assessment

Inspect the cortical margins for discontinuity and displacement. Evaluate adjacent soft tissues and lung fields for associated injury. Report fracture location relative to anatomic landmarks for surgical planning if needed.

Rib Series AP Upright
4
Feb

Overview

AP rib radiographs evaluate suspected rib fractures and chest wall pathology. Images are obtained with the patient upright and centered to the area of interest. Multiple projections may be required to visualize the entire rib arc.

Technique

Obtain separate views for upper and lower ribs as needed with appropriate collimation. Use oblique projections to profile ribs and reduce overlap with the spine. Provide pain control and positioning aids for patient comfort.

Clinical Indications

Rib series are indicated for trauma chest pain and suspected fractures. They help detect displaced fractures and associated complications such as pneumothorax. CT is more sensitive for occult fractures when radiographs are inconclusive.

Image Assessment

Evaluate cortical continuity and callus formation on follow up studies. Assess for adjacent lung injury and pleural air or fluid. Document fracture location and displacement for clinical management.