AP PROJECTION

Pathology demonstrated :

Fractures and other pathology of scapula.

IR size :

24 × 30 cm (10 × 12 inches).

IR POSITION :

Lengthwise / inpucky.

Shielding :

Shield radiosensitive tissues outside region of interes.

Patient position :

Perform radiograph with patient in erect or supine position. (The erect position may be more comfortable for the patient.) Posterior surface of shoulder is in direct contact with tabletop or IR without rotation of thorax. (Rotation toward affected side would place the scapula into a truer posterior position, but this also would result in greater superimposition of the rib cage.).

Part position :

Position patient so that midscapula area is centered to CR.

• Adjust cassette to center to CR. Top of IR should be about 2 inches (5 cm) above shoulder, and lateral border of IR should be about 2 inches (5 cm) from lateral margin of rib cage.

• Gently abduct arm 90°, and supinate hand. (Abduction moves scapula laterally to clear more of the thoracic structures).

CR :

CR perpendicular to midscapula, 2 inches (5 cm) inferior to coracoid process, or to level of axilla, and approximately 2 inches (5 cm) medial from lateral border of pt.

Collimation :

Closely collimate on four sides to area of scapula.

note: Respiration Orthostatic (breathing) technique is preferred if patient can cooperate. Ask patient to breathe gently without moving affected shoulder or arm.

Criteria :

Anatomy Demonstrated: 

• Lateral portion of the scapula is free of superimposition. 

• Medial portion of the scapula is seen through the thoracic structures.

Position: 

• Affected arm seen to be abducted 90° and hand supinated, as evidenced by the lateral border of the scapula free of superimposition. 

• Collimation to area of interest.