LATERAL POSITION: pt Erect

Pathology demonstrated :

Horizontal fractures of the scapula; arm placement should be determined by scapular area of interest.

IR size :

24 × 30 cm (10 × 12 inches).

IR POSITION :

lengthwise / inpucky.

Shielding :

Secure gonadal shield around waist.

Patient position :

Perform radiograph with patient in erect or recumbent position. (The erect position is preferred if patient’s condition allows.) Face patient toward IR in anterior oblique position.

Part position :

• Have patient reach across front of chest and grasp opposite shoulder. This best demonstrates body of scapula (Figs. 5-90 and 5-91).

• Have patient drop affected arm, flex elbow, and place arm behind lower back with arm partially abducted, or just let arm hang down at patient’s side. This best demonstrates acromion and coracoid processes.

• Palpate superior angle of the scapula and AC joint articulation. Rotate the patient until an imaginary line between the two points is perpendicular to IR; this results in a lateral position of the body of the scapula. The position of the humerus (down at side or up across anterior chest) has an effect on the amount of body rotation required. Less rotation is required with arm up across anterior chest. (The flat posterior surface of body of scapula should be perpendicular to IR.)

• Align patient to center midvertebral border to CR and to IR.

CR :

CR to midvertebral border of scapula.

Collimation :

Closely collimate to area of scapula.

Note ; Respiration : Suspend respiration during exposure.

Criteria :

Anatomy Demonstrated and Position: 

• Entire scapula should be visualized in a lateral position, as evidenced by direct superimposition of vertebral and lateral borders. 

• True lateral is shown by direct superimposition of vertebral and lateral borders. 

• Body of scapula should be in profile, free of superimposition by ribs. 

• As much as possible, the humerus should not superimpose area of interest of the 

scapula. 

• Collimation to area of interest.

Exposure: 

• Optimal exposure with no motion demonstrates sharp bony borders and trabecular markings without excessive density (brightness) in area of inferior angle. 

• Bony borders of both acromion and coracoid processes should be seen through the head of the humerus.