You have a formal request for a radiologic examination of the scapula. 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.
d. Letter markers.
f. Positioning sponges.
g. Lead shielding.
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 the patient as necessary.
(2) Ensure the patient's clothing is removed as required.
NOTE: Gown the patient as necessary.
c. Explain the procedure as 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 film cassette.
NOTE: Use a 10" X 12" cassette for both views.
7. Place the cassette in the bucky lengthwise.
8. Position the overhead tube.
a. Set the tube angle vertical perpendicular to the film if the patient is supine or horizontal perpendicular if the patient is erect.
b. Set the source to image receptor distance (SID) to 40 inches (101 cm).
c. Center the tube to the cassette.
d. Adjust the conefield to full field coverage.
9. Position the scapula.
a. AP view.
(1) Place the patient supine or erect with the arm of the side of interest abducted 90 degrees and hand supinated.
(2) Center the coracoid process over the centerline of the table.
(3) Place the posterior surface of shoulder in direct contact with tabletop without rotation of thorax.
(4) Position the patient so that the center point of the film is to mid-scapula area, which is 2" inferior to the coracoid process.
b. Lateral view.
(1) Stand the patient upright facing the table.
(2) Place the arm of the affected side across the front of the body with the palm resting on the opposite shoulder.
(3) Palpate borders of scapula and rotate patient until the scapula is in a true lateral position.
NOTE: The average patient will be rotated 30 to 40 degrees from the lateral position.
(4) Central ray directed to mid-vertebral border of scapula, perpendicular to film.
NOTE: A fracture of the body of the scapula is best demonstrated by the lateral view.
10. Place the appropriate identification marker on the cassette.
11. Place the lead apron across the patient's lap.
NOTE: Secure the lead apron across the patient's lap for the lateral view.
12. Tell the patient, "STOP BREATHING AND DO NOT MOVE."
13. Make the exposure.
14. Tell the patient, "RELAX AND BREATHE NORMALLY."
15. Process the film.