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X-RAY THE SHOULDER

X-Ray Images the Shoulder


You have a formal request for a radiologic examination of the shoulder. You have the assistance of additional personnel if required. You will need a properly equipped X-ray exposure room with various sizes of film in cassettes, sandbags, lead apron, letter markers, calipers, and various sponges.

1.  Select the required view(s) based on the request.

2.  Gather the necessary materials and supplies.

a.  Appropriate cassettes.

b.  Radiographic film.

c.  Sandbags.

d.  Letter markers.

e.  Tape.

f.  Positioning sponges.

g.  Lead shielding.

h.  Calipers.

3.  Prepare the patient.

a.  Bring the patient into the X-ray room.

b.  Ensure the patient is properly dressed.

(1)  Ensure foreign objects are removed from patient as necessary.

(2)  Ensure the patient's clothing is removed as required.

(3)  Use a drape sheet or patient gown to cover the patient as needed.

c.  Explain the procedure if applicable.

d.  Assist the patient onto the X-ray table.

4.  Measure the body part through the entry-exit site of the central ray.

5.  Set the control panel.

a.  Consult the technique chart.

b.  Set the appropriate mAs and kVp on the control panel.

6.  Select the proper size cassette.

NOTE: Use a 10" X 12" cassette for the AP internal/external views.

7.  Position the cassette.

a.  Place the cassette crosswise in the bucky for the AP internal/external views.

b.  Place the cassette lengthwise on the tabletop for the inferiosuperior axial view.

8.  Position the overhead tube.

a.  Set the tube angle perpendicular to the film.

b.  Set the source to image receptor distance (SID) to 40 inches (101cm).

c.  Adjust the conefield to full field coverage.

9.  Position the shoulder.

a.  AP external rotation.

(1)  Place the patient supine or erect with the coracoid process over the centerline of the table.

(2)  Rotate the coronal plane 10 to 15 degrees toward the affected side.

(3)  Place the arm in full extension with the epicondyles parallel to the tabletop.

(4)  Place the acromion process 2" below the upper edge of the cassette.

b.  AP internal rotation.

(1)  Place the patient supine or erect with the coracoid process over the centerline of the table.

(2)  Rotate the coronal plane 10 to 15 degrees toward the affected side.

(3)  Rotate the humerus internally, placing the epicondyles perpendicular to the tabletop.

(4)  Place the acromion process 2" below the upper edge of the cassette.

10.  Immobilize the body part as required.

a.  Place a sandbag on or against the hand for the AP internal/external views.

b.  Place a sandbag under the hand and wrist for the inferiosuperior axial view.

11.  Place the appropriate identification marker on the cassette.

12.  Place the lead apron across the patients lap.

13.  Tell the patient, "DO NOT BREATHE OR MOVE."

14.  Make the exposure.

15.  Tell the patient, "RELAX AND BREATHE NORMALLY," and remove immobilization.

16.  Process the film.

 

David L. Heiserman, Editor

Copyright   SweetHaven Publishing Services
All Rights Reserved

Revised: June 06, 2015