Pathology demonstrated:

•Fracture and dislocation of the humerus

•Pathologic processes including osteoporosis

IR size:

• For larger patient, 35 × 43 cm (14 × 17 inches) • For smaller patient, 30 × 35 cm (11 × 14 inches)

IR POSITION:

Lengthwise / inpucky

Shielding:

Shield radiosensitive tissues outside region of interest.

Patient position:

Position patient erect or supine. 

Adjust the height of the cassette so that shoulder and elbow joints are equidistant from ends of IR.

Part position:

• Rotate body toward affected side as needed to bring shoulder and proximal humerus in contact with cassette.

• Align humerus with long axis of IR, unless diagonal placement is needed to include both shoulder and elbow joints.

• Extend hand and forearm as far as patient can tolerate.

• Abduct arm slightly and gently supinate hand so that epicondyles of elbow are parallel and equidistant from IR.

CR:

CR perpendicular to IR, directed to midpoint of humerus

Collimation:

Collimate on sides to soft tissue borders of humerus and shoulder. (Lower margin of collimation field should include the elbow joint and about 2.5 cm [1 inch] minimum of proximal forearm.)

criteria:

Anatomy Demonstrated:

•AP projection shows the entire humerus, including the shoulder and elbow joints.

Position:

•Long axis of humerus should be aligned with long axis of IR.

•True AP projection is evidenced at proximal humerus by the following: greater tubercle is seen in profile laterally; humeral head is partially seen in profile medially, with minimal superimposition of the glenoid cavity.

•Distal humerus: lateral and medial epicondyles both are visualized in profile.

•Collimation to area of interest.

Exposure:

•Optimal density (brightness) and contrast with no motion visualize sharp cortical margins and clear, bony trabecular markings at both proximal and distal portions of the humerus.