Tag Archives: shoulder

Arthrogram Shoulder
4
Feb

Overview

Shoulder arthrography injects contrast into the glenohumeral joint under imaging guidance to evaluate labral tears and rotator cuff pathology. Fluoroscopic or ultrasound guidance ensures accurate intra articular placement. Arthrography is often combined with MRI for enhanced soft tissue visualization.

Technique

Perform sterile joint injection under fluoroscopic or ultrasound guidance and confirm intra articular contrast distribution. Use appropriate contrast type and volume for the planned imaging study. Monitor the patient for immediate adverse reactions.

Clinical Indications

Arthrogram is indicated for suspected labral tear adhesive capsulitis and occult rotator cuff pathology. It enhances detection of intra articular abnormalities when MRI alone is inconclusive. Post procedure MRI or CT arthrography provides detailed assessment.

Image Assessment

Evaluate contrast filling defects labral detachment and capsular irregularity. Assess for contrast extravasation indicating capsular rupture. Report findings to guide surgical planning and arthroscopic intervention.

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.

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 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 AP with Weights
4
Feb

Overview

AP shoulder views with weights in the hands accentuate inferior subluxation and rotator cuff arthropathy. The patient stands holding light weights to apply gentle traction. Comparison with non weighted views highlights dynamic changes.

Technique

Obtain standard AP shoulder radiographs with the patient holding equal weights in both hands. Ensure consistent exposure and positioning between weighted and non weighted views. Use caution in painful or unstable shoulders.

Clinical Indications

Weighted views are indicated for suspected chronic rotator cuff tear and inferior subluxation. They help demonstrate humeral head migration under load. MRI provides soft tissue detail when indicated.

Image Assessment

Compare humeral head position relative to the glenoid with and without weights. Assess for superior migration and joint space narrowing. Report findings relevant to surgical planning and rehabilitation.