Pathology demonstrated:

linical Indications

• Fractures or dislocations of proximal

humerus and shoulder girdle

• Calcium deposits in muscles, tendons, or

bursal structures

• Degenerative conditions including osteo- porosis and osteoarthritis 

IR size : • IR size—24 × 30 cm (10 × 12 inches), crosswise (or lengthwise to demonstrate entire humerus if injury includes proximal half of humerus) 

SID: 100cm

Shield radiosensitive tissues outside region of interest. 

Patient position : 

Perform radiograph with the patient in an erect

or supine position. (The erect position is usually less painful for

patient, if condition allows.) Rotate body slightly toward affected

side, if necessary, to place shoulder in contact with IR or tabletop. 

Part position:

Position patient to center scapulohumeral joint to center of IR.

• Abduct extended arm slightly; internally rotate arm (pronate

hand) until epicondyles of distal humerus are perpendicular to IR. 

 CR : CR perpendicular to IR, directed to 1 inch (2.5 cm) inferior to

coracoid process (see Note on preceding page) 

Collimation :Collimate on four sides, with lateral and upper borders adjusted to soft tissue margins.

 criteria : 

Anatomy Demonstrated: • Lateral view of proximal humerus

and lateral two-thirds of clavicle and upper scapula is

demonstrated, including the relationship of the humeral head

to the glenoid cavity.

Position: • Full internal rotation position is evidenced by

lesser tubercle visualized in full profile on the medial aspect

of the humeral head. • An outline of the greater tubercle

should be visualized superimposed over the humeral

head. • Collimation to area of interest.

Exposure: • Optimal density (brightness) and contrast with

no motion demonstrate clear, sharp bony trabecular markingswith soft tissue detail visible for possible calcium deposits 

pathology demonstrated :

Fractures or dislocations of proximal

humerus

• Fractures of glenoid labrum or brim

• Bankart lesion, erosion of glenoid rim, the

integrity of the scapulohumeral joint, and other degenerative conditions 

IR size : IR size—18 × 24 cm (8 × 10 inches), crosswise 

crosswise \ inpucky 

Shield radiosensitive tissues outside region of interest. 

Patient position :

Perform radiograph with patient in an erect or

supine position. (The erect position is usually less painful for patient, if condition allows.) 

Part position:

• Rotate body 35° to 45° toward affected side (see Note). If the

radiograph is performed with the patient in the supine position,

place supports under elevated shoulder and hip to maintain this

position.

• Center midscapulohumeral joint to CR and to center of IR.

• Adjust cassette so that top of IR is about 2 inches (5 cm) above

shoulder and side of IR is about 2 inches (5 cm) from lateral

border of humerus.

• Abduct arm slightly with arm in neutral rotation. 

CR : CR perpendicular to IR, centered to scapulohumeral joint, which

is approximately 2 inches (5 cm) inferior and medial from the superolateral border of shoulder 

Collimation 

Collimation : Collimate so that upper and lateral borders of the field are to the soft tissue margins. 

criteria :

Anatomy Demonstrated: • Glenoid cavity should be seen in

profile without superimposition of humeral head.

Position: • Scapulohumeral joint space should be open.

• Anterior and posterior rims of glenoid cavity are superimposed.

• Collimation to area of interest.

Exposure: • Optimal density (brightness) and contrast with

no motion visualize soft tissue margins and clear, sharp bony

trabecular markings. • Soft tissue detail of the joint space and axilla should be visualized. 

Pathology demonstrated :

Optimal trauma projection for possible

scapulohumeral dislocations (especially

posterior dislocations)

• Glenoid fractures, Hill-Sachs lesions, and soft tissue calcifications*

 IR size : IR size—24 × 30 cm (10 × 12 inches), lengthwise 

Shield radiosensitive tissues outside region of interest 

lengthwise \ inpucky 

Patient position :

Perform radiograph with patient in erect or supine

position. (The erect position is usually less painful, if patient’s condi-

tion allows.) Rotate body 45° toward affected side (posterior

surface of affected shoulder against IR). 

Part position:

Center scapulohumeral joint to CR and mid-IR.

• Adjust IR so that 45° CR projects scapulohumeral joint to the

center of IR.

• Flex elbow and place arm across chest, or with trauma, place

arm at side as is. 

CR : CR 45° caudad, centered to scapulohumeral joint

 Collimation : Collimate closely to area of interest. 

criteria : 

Anatomy Demonstrated: • Humeral head, glenoid cavity, and

neck and head of the scapula are well demonstrated free of

superimposition.

Position: • The coracoid process is projected over part of the

humeral head, which appears elongated. • Acromion and AC

joint are projected superior to the humeral head. • Collimation

to area of interest.

Exposure: • Optimal density (brightness) and contrast with

no motion demonstrate clear, sharp bony trabecular markings and soft tissue detail for possible calcifications.