UPPER LIMBS

RADIOGRAPHIC POSITIONING
TOPICS
■ FINGERS – AP, PA, LATERAL
■ HAND – AP, PA, LATERAL, OBLIQUE, BALL CATCHERS VIEW, BUTTERFLY VIEW
BURMAN METHOD FOLIO METHOD
■ WRIST – AP, PA, LATERAL, OBLIQUE, ULNAR DEVIATION, RADIAL DEVIATION,
CARPAL TUNNEL VIEW – I ,II, CARPAL BRIDGE VIEW
■ FOREARM – AP, LATERAL
■ ELBOW. – AP, LATERAL, ULNAR GROOVE, OLECRANON PROCESS, DISTAL
HUMERUS
■ HUMERUS – AP, LATERAL, TRANS THORACIC LATERAL LAWRENCE METHOD.
■ SHOULDER. – AP, SUPERIOR TO INFERIOR, INFERIOR TO SUPERIOR, STRYKERS VIEW,
CLEMENTS VIEW, RAFFERT VIEW, WEST POINT VIEW, GREYSHAY VIEW,
GARTH VIEW, TANGENTIAL BICIPITAL GROOVE , VALPEAU VIEW
■ CLAVICLE – AP, PA, INFERIOR TO SUPERIOR, ZANCA VIEW
■ SCAPULA – AP, Y VIEW
FINGERS
THUMB – AP VIEW
■ AIM
To demonstrate the thumb finger.
■ GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
■ PATIENT POSITION
1. Patient to seat near the X ray Couch.
2. 10 x 8 Cassette is placed over the edge of the X ray couch.
3. Affected hand should be placed over the 10 x 8 Cassette in Supine Position.
4. Hand is rotated laterally until the dorsal portion of thumb contact the Cassette.
5. Hand Should be immobilized
■ CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through the first metacarpal.
■ EXPOSURE FACTOR
KV = 40-46
MA = 100
MAS = 4-6
FFD = 90 CM
THUMB PA VIEW
AIM
To demonstrate the thumb finger.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
10 x 8 Cassette is placed over the edge of the X ray couch.
Affected hand should be placed over the 10 x 8 Cassette in Prone Position.
Hand is rotated laterally 90 degree and the thumb is abducted.
Hand Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through the first metacarpal.
EXPOSURE FACTOR
KV = 40-46
MA = 100
MAS = 4-6
FFD = 90 CM
THUMB LATERAL VIEW
AIM
To demonstrate the thumb finger.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
10 x 8 Cassette is placed over the edge of the X ray couch.
Affected hand should be placed over the 10 x 8 Cassette in Prone Position.
Hand is rotated medially until the lateral aspect of thumb contact the Cassette.
Hand Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through the first metacarpal.
EXPOSURE FACTOR
KV = 40-46
MA = 100
MAS = 4-6
FFD = 90 CM
 INDEX AND MIDDLE FINGERS - AP VIEW
AIM

To demonstrate the Index and middle finger.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Supine Position.

Index and middle fingers should be extended and separated. Other fingers should be folded

Hand Should be immobilized

CENTERING OF X RAY TUBE

Tube is vertical so that central ray should pass through the second and third metacarpal.

EXPOSURE FACTOR

KV = 40-46

. MA = 100

MAS = 4-6
INDEX AND MIDDLE FINGER – PA VIEW
AIM

To demonstrate the Index and middle finger.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Prone Position.

Index and middle fingers should be extended and separated. Other fingers should be folded

Hand Should be immobilized

CENTERING OF X RAY TUBE

Tube is vertical so that central ray should pass through the second and third metacarpals.

EXPOSURE FACTOR

KV = 40-46

. MA = 100

MAS = 4-6
INDEX
AIM
AND MIDDLE FINGERS LATERAL VIEW
To demonstrate the Index and middle finger.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Prone Position.
. Hand is rotated laterally 90 degree.
Index and middle fingers should be extended and separated. Other fingers should be folded.
Hand Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through the second and third metacarpals.
EXPOSURE FACTOR
KV = 40-46
. MA = 100
MAS = 4-6
RING AND LITTLE FINGERS AP VIEW
AIM

To demonstrate the Ring and Little finger.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Supine Position.

Ring and little fingers should be extended and separated. Other fingers should be folded

Hand Should be immobilized

CENTERING OF X RAY TUBE

Tube is vertical so that central ray should pass through the between fourth and fifth metacarpals.

EXPOSURE FACTOR

KV = 40-46

. MA = 100

MAS = 4-6
RING AND LITTLE FINGERS PA VIEW
AIM

To demonstrate the Ring and little finger.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Prone Position.

Ring and little fingers should be extended and separated. Other fingers should be folded

Hand Should be immobilized

CENTERING OF X RAY TUBE

Tube is vertical so that central ray should pass between the fourth and fifth metacarpals.

EXPOSURE FACTOR

KV = 40-46

. MA = 100

MAS = 4-6
RING AND LITTLE FINGERS LATERAL VIEW
AIM

To demonstrate the Index and middle finger.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Prone Position.

. Hand is rotated laterally 90 degree.

Ring and little fingers should be extended and separated. Other fingers should be folded.

Hand Should be immobilized

CENTERING OF X RAY TUBE

Tube is vertical so that central ray should pass between the fourth and fifth metacarpals.

EXPOSURE FACTOR

KV = 40-46

. MA = 100

MAS = 4-6
HAND AP VIEW
AIM

To demonstrate the bones and soft tissue of hand including carpals, metacarpals and phalanges.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Supine Position. Fingers are extended and separated.

Wrist and Elbow joints are parallel to the Cassette.

Hand Should be immobilized

CENTERING OF X RAY TUBE

Tube is vertical so that central ray should pass through third metacarpal.

EXPOSURE FACTOR

KV = 46-48

. MA = 100

MAS = 8-10
HAND PA VIEW
AIM

To demonstrate the bones and soft tissue of hand including carpals, metacarpals and phalanges.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Prone Position. Fingers are extended and separated.

Wrist and Elbow joints are parallel to the Cassette.

Hand Should be immobilized

CENTERING OF X RAY TUBE

Tube is vertical so that central ray should pass though third metacarpal.

EXPOSURE FACTOR

KV = 46-48

. MA = 100

MAS = 8-10
HAND LATERAL VIEW
AIM

To demonstrate the bones and soft tissue of hand including carpals, metacarpals and phalanges.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Prone Position.
The hand is rotated laterally 90 degree. Fingers should be overlapped.
Hand Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through third metacarpal.
EXPOSURE FACTOR
KV = 46-48
. MA = 100
MAS = 8-10
FFD = 90 CM
HAND OBLIQUE VIEW
AIM

To demonstrate the bones and soft tissue of hand including carpals, metacarpals and phalanges.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Prone Position.

The hand is rotated laterally 45 degree. Fingers should be Separated.

Hand Should be immobilized

CENTERING OF X RAY TUBE

Tube is vertical so that central ray should pass through third metacarpal.

EXPOSURE FACTOR

KV = 46-48

. MA = 100

MAS = 8-10
HAND AXIAL VIEW – BALL CATCHERS VIEW
AIM

To demonstrate the fractures and early stage of rheumatoid arthritis.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

12 x 10 Cassette is placed over the edge of the X ray couch.

Both hands are placed over the 12 x 10 Cassette in Supine Position.
Both hands are rotated medially 45 degree. Fingers are extended.
Forearm and Shoulder are parallel to the Cassette.
Hand Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between fifth metacarpal.
EXPOSURE FACTOR
KV = 46-48
. MA = 100
MAS = 8-10
HAND AXIAL VIEW – BUTTERFLY VIEW
AIM

To demonstrate the fractures and early stage of rheumatoid arthritis.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

12 x 10 Cassette is placed over the edge of the X ray couch.

Both hands are placed over the 12 x 10 Cassette in Prone Position.
Both hands are rotated laterally until the dorsal portion of thumb fingers meet each other.
Forearm and Shoulder are parallel to the Cassette.
Hand Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between first metacarpal.
EXPOSURE FACTOR
KV = 46-48
. MA = 100
MAS = 8-10
HAND – CMC JOINT ROBERT METHOD
AIM

To demonstrate the First Carpometacarpal joint spaces, base of first metacarpal and trapezium.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient seated near the X ray Couch.

10 x 8 Cassette is placed over the edge of the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Prone Position.

The hand is rotated towards radial side until the dorsal aspect of thumb contact the cassete.

Hand Should be immobilized

CENTERING OF X RAY TUBE

Tube is vertical so that central ray should pass through first CMC joint.

EXPOSURE FACTOR

KV = 46-48

. MA = 100

MAS = 10 - 12
 HAND – CMC JOINT BURMAN METHOD
AIM

To demonstrate the First Carpometacarpal joint spaces, base of first metacarpal (convex) and trapezium ( concave ).

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient seated near the X ray Couch.

10 x 8 Cassette is placed over the X ray couch.

Affected hand should be placed over the 10 x 8 Cassette in Prone Position.

The hand is rotated laterally 90° and cup the hand keeping the metacarpals in line with forearm.

Hand Should be immobilized

CENTERING OF X RAY TUBE

Tube is vertical and tilted 45° Cranially ( towards head ) so that central ray should pass through first CMC joint.

EXPOSURE FACTOR

KV = 46-48

. MA = 100
MAS = 10-12
HAND – FOLIO METHOD ( SKIERS THUMB )
AIM
To demonstrate the First Carpometacarpal joint spaces and useful for diagnosis of ULNAR collateral ligament rupture.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient seated near the X ray Couch.
12 x 10 Cassette is placed over the X ray couch.
Both hands should be placed over the 12 x 10 Cassette in lateral Position.
Rubber band is placed around the distal portion of both thumbs and a roll of medical tape is placed between the
first metacarpals.
The first CMC Joints of both hands must make contact with the medical tape between them.
Thumb fingers should be in Prone position and are pulled in. Thumbnails should be parallel to Cassette.
Hand Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between two hands.
EXPOSURE FACTOR
KV = 45-50
. MA = 100
MAS = 15-20
FFD = 90 CM
WRIST – AP VIEW
AIM

To demonstrate the carpal bones, Distal end of radius, ulna , Proximal end of metacarpals and soft tissue of wrist.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected wrist should be placed over the middle of 10 x 8 Cassette in Supine Position.
Wrist is adjusted so that both styloid process is at equidistant.
Forearm and Shoulder joint should be parallel to the Cassette.
Wrist Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between styloid process of radius and ulna.
EXPOSURE FACTOR
KV = 45-50
. MA = 100
MAS = 10-12
FFD = 90 CM Collimated
WRIST – PA VIEW
AIM

To demonstrate the carpal bones, Distal end of radius, ulna , Proximal end of metacarpals and soft tissue of wrist.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected wrist should be placed over the middle of 10 x 8 Cassette in Prone Position.
Wrist is adjusted so that both styloid process is at equidistant.
Forearm and Shoulder joint should be parallel to the Cassette.
Wrist Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between styloid process of radius and ulna.
EXPOSURE FACTOR
KV = 45-50
. MA = 100
MAS = 10-12
FFD = 90 CM Collimated
WRIST – LATERAL VIEW
AIM

To demonstrate the carpal bones, Distal end of radius, ulna , Proximal end of metacarpals and soft tissue of wrist.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected wrist should be placed over the middle of 10 x 8 Cassette in Prone Position.
Wrist is rotated laterally 90°. Thumb is abducted.
Wrist is adjusted so that both styloid process is at superimposed.
Forearm and Shoulder joint should be parallel to the Cassette.
Wrist Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through Radial styloid process.
EXPOSURE FACTOR
KV = 45-50
. MA = 100
MAS = 10-12
WRIST – OBLIQUE VIEW
AIM

To demonstrate the carpal bones, Distal end of radius, ulna , Proximal end of metacarpals and soft tissue of wrist.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected wrist should be placed over the middle of 10 x 8 Cassette in Prone Position.
Wrist is rotated medially 45°.
Forearm and Shoulder joint should be parallel to the Cassette.
Wrist Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between styloid process of radius and ulna.
EXPOSURE FACTOR
KV = 45-50
. MA = 100
MAS = 10-12
FFD = 90 CM Collimated
WRIST – AXIAL VIEW

ULNAR DEVIATION ( SCAPHOID VIEW )

AIM

To demonstrate the scaphoid and its adjacent articulations, carpals, open space between lateral carpals and soft tissues and trabecular areas of the
wrist..

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected wrist should be placed over the middle of 10 x 8 Cassette in Prone Position.
Fingers are rotated towards ulnar side.
Forearm is adjusted so that both styloid process are at equidistant.
Shoulder is depressed at the level of wrist join
Wrist Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between styloid process of radius and ulna.
EXPOSURE FACTOR
KV = 45-50. MAS = 10-12
. MA = 100. FFD = 90 CM Collimated
WRIST – AXIAL VIEW

RADIAL DEVIATION
AIM

To demonstrate the carpals and its articulations in the medial wrist, the open space between medial carpals, and soft tissues and bony
trabecular areas of the wrist..

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected wrist should be placed over the middle of 10 x 8 Cassette in Prone Position.
Fingers are rotated towards radial side.
Forearm is adjusted so that both styloid process are at equidistant.
Shoulder is depressed at the level of wrist join
Wrist Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between styloid process of radius and ulna.
EXPOSURE FACTOR
KV = 45-50. MAS = 10-12
. MA = 100. FFD = 90 CM Collimated
WRIST – AXIAL VIEW

CARPAL TUNNEL VIEW FIRST METHOD

AIM

This view is for identifying abnormalities of the tissues in the canal and fractures of hamate, trapezium, and pisiform bones.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION
Patient to stand backward towards the X ray Couch.
10 x 8 Cassette is placed at the edge of the X ray couch.
Affected side palm of the hand is pressed on the middle of the 10 x 8 Cassette.
The affected wrist is dorsiflexed approximately 135°
Wrist Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between styloid process of radius and ulna.
EXPOSURE FACTOR
KV = 45-50. MAS = 10-12
. MA = 100. FFD = 90 CM Collimated
CARPAL TUNNEL VIEW SECOND METHOD
( GAYNOR HART METHOD )
AIM

This view is for identifying abnormalities of the tissues in the canal and fractures of hamate, trapezium, and pisiform bones

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION
Patient to seated near the X ray Couch.
10 x 8 Cassette is placed over a plastic block approximately 8 cm.
Affected wrist is placed over the middle of the 10 x 8 Cassette in Prone position.
The fingers are dorsiflexed approximately 135°
The position is maintained with the help of bandage roll hold by Patient.
Wrist Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between styloid process of radius and ulna.
EXPOSURE FACTOR
KV = 45-50. MAS = 10-12
. MA = 100. FFD = 90 CM Collimated
WRIST – TANGENTIAL CARPAL BRIDGE VIEW (1)

AIM

To demonstrate the Scaphoid fractures, calcifications, lunate dislocations, presence of foreign bodies in dorsum area of the wrist, and chip
fractures of the dorsal surface of the carpals.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION
Patient to stand near the X ray Couch.
Affected side dorsal aspect of hand is pressed on the 10 x 8 Cassette.
Forearm should be perpendicular to the Cassette.
Wrist Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical and tilted 45° caudally (towards feet ) so that central ray should pass through 1.5 inches above the bend at wrist.
EXPOSURE FACTOR
KV = 45-50. MAS = 10-12
. MA = 100. FFD = 90 CM Collimated
WRIST – TANGENTIAL CARPAL BRIDGE VIEW (2)

AIM

To demonstrate the Scaphoid fractures, calcifications, lunate dislocations, presence of foreign bodies in dorsum area of the wrist, and chip fractures
of the dorsal surface of the carpals.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION
Patient to seated near the X ray Couch.
10 x 8 cassete is placed vertically with a support.
Elevate the affected side forearm and flex the wrist downwards.
Affected side dorsal aspect of hand make contact with the Cassette.
Forearm should be perpendicular to the Cassette.
The position is maintained with the help of pillow.
Wrist Should be immobilized
CENTERING OF X RAY TUBE
Tube is vertical and tilted 45° caudally (towards feet ) so that central ray should pass through 1.5 inches above the bend at wrist.
EXPOSURE FACTOR
KV = 45-50. MAS = 10-12
. MA = 100. FFD = 90 CM Collimated
FOREARM – AP VIEW
AIM

To demonstrate the radius and ulna and soft tissue of Forearm.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION
Patient to seated near the X ray Couch.
Forearm is placed over 15 x 12 Cassette in supine position including wrist and elbow Joints.
Shoulder is depressed at the level of forearm.
Forearm is adjusted so that both styloid process are at equidistant.
Forearm is immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between wrist and elbow joint.
EXPOSURE FACTOR
KV = 50-52.
MAS = 10-12
. MA = 100.
FFD = 90 CM Collimated
FOREARM – LATERAL VIEW
AIM

To demonstrate the radius and ulna and soft tissue of Forearm.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION
Patient to seated near the X ray Couch.
Affecter Forearm is placed in supine position over the X ray couch. Elbow is flexed 90° and rotated internally.
Hand is perpendicular to the Cassette.
Big Cassette placed under the forearm including wrist and elbow joints.
Shoulder is depressed at the level of forearm.
Forearm is adjusted so that both styloid process are at superimposed.
Forearm is immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between wrist and elbow joint.
EXPOSURE FACTOR
KV = 50-52. MAS = 10-12
. MA = 100. FFD = 90 CM Collimated
ELBOW – AP VIEW
AIM

This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the elbow joint and soft tissue of
the elbow.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Shoulder is depressed at the level of forearm.
Elbow is adjusted so that both epicondyles are at equidistant.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass at 2.5 cm distal end of elbow.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 10-12. FFD = 90 CM Collimated
ELBOW – AP VIEW ( FOREARM CONTACT )
AIM

This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the elbow joint and soft tissue of
the elbow.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Forearm is adjusted so that posterior aspect of forearm contact the Cassette and both epicondyles are at equidistant
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass at 2.5 cm distal end of elbow.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 10-12. FFD = 90 CM Collimated
ELBOW – AP VIEW ( ARM CONTACT )
AIM

This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the elbow joint and soft tissue of
the elbow.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Shoulder is depressed at the level of forearm.
Arm should contact the Cassette and Forearm is slightly raised.
Elbow is adjusted so that both epicondyles are at equidistant
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between two epicondyles.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 10-12. FFD = 90 CM Collimated
ELBOW – LATERAL VIEW ( TYPE 1 )
AIM

This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the elbow joint and soft tissue of
the elbow. Soft tissue of the fat pads should be visible.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is flexed 90° and rotated internally.
The palm of the hand is perpendicular to the couch. Fingers should be overlapped.
Shoulder is depressed at the level of forearm. Elbow is adjusted so that both epicondyles are superimposed.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through lateral epicondyle.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – LATERAL VIEW ( TYPE 2 )
AIM

This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the elbow joint and soft tissue of
the elbow. Soft tissue of the fat pads should be visible.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is flexed 90° and rotated internally.
The palm of the hand is facing the X ray couch.
Shoulder is depressed at the level of forearm.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through lateral epicondyle.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – LATERAL VIEW ( TYPE 3 )
AIM

This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the elbow joint and soft tissue of
the elbow. Soft tissue of the fat pads should be visible.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is flexed 90° and rotated internally.
The palm of the hand is facing the outwards.
Shoulder is depressed at the level of forearm.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through lateral epicondyle.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – ULNAR GROOVE VIEW
AIM

To demonstrate the ulnar groove through which ulnar nerve passes.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is fully flexed until the palm of the hand facing the shoulder.
Forearm is slightly abducted.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through medial epicondyle of humerus.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – DISTAL HUMERUS VIEW
AIM

To demonstrate the distal end of humerus, Olecranon process.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat sideways near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Forearm should rest on the cassette
Elbow rotated internally making the humerus 75° Angle from the forearm
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through Olecranon process.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – OLECRANON PROCESS PA AXIAL VIEW
AIM

This view should demonstrate the bones and soft tissue of the elbow joint specifically the olecranon process and articular margin of the
olecranon and humerus.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat sideways near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Forearm should rest on the cassette.
Elbow rotated internally making the humerus 45° angle from the forearm.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 20° caudally (towards feet) so that central ray should pass through Olecranon process.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – JONES VIEW

AIM

To demonstrate the fractures and moderate dislocation of the elbow in acute flexion.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette with forearm acutely flexed.
Elbow is fully flexed until the palm of the hand touches the shoulder.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through medial epicondyle of humerus.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – COYLE’S METHOD
AIM

This view should demonstrate the radial head.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient to seat near the X ray Couch.

Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is flexed 90° and rotated internally.
The palm of the hand is facing the X ray couch.
Shoulder is depressed at the level of forearm.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 45° inwards ( towards humerus ) so that central ray should pass through lateral epicondyle.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
HUMERUS – AP VIEW
AIM

This view should demonstrate the bones and soft tissue of the upper arm, specifically the full length of the humerus, elbow and shoulder joints,
and epicondyles.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient lying supine position over the X ray Couch.

Affected arm and forearm are extended and abducted.
Big Cassette placed under the humerus including elbow and shoulder joints.
Humerus is adjusted so that both epicondyles are at equidistant.
Unaffected side is slightly raised so that the affected side contact the Cassette.
Humerus is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between elbow and shoulder joints.
EXPOSURE FACTOR
KV = 55-60. MA = 100
MAS = 15-20. FFD = 90 CM Collimated
HUMERUS – LATERAL VIEW
AIM

This view should demonstrate the bones and soft tissue of the upper arm, specifically the full length of the humerus, elbow and shoulder joints,
and epicondyles.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient lying supine position over the X ray Couch.

Affected side forearm is flexed 90° and rotated medially. The palm of the hand is perpendicular to abdomen.
Big Cassette placed under the humerus including elbow and shoulder joints.
Humerus is adjusted so that both epicondyles are at superimposed.
Unaffected side is slightly raised so that the affected side contact the Cassette.
Humerus is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between elbow and shoulder joints.
EXPOSURE FACTOR
KV = 55-60. MA = 100
MAS = 15-20. FFD = 90 CM Collimated
HUMERUS – TRANSTHORACIC LATERAL LAWRENCE VIEW
AIM

This view should demonstrate the bones and soft tissue of the humerus and shoulder including the proximal humerus superimposed with structures
of the thorax.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION
Patient standing near the chest stand in lateral position.
Big Cassette placed in chest stand upper border above shoulder lower border below elbow joint.
Unaffected side forearm is flexed and palm of the hand touches the back side of head.
Shoulder is elevated as much as possible.Elevation of the uninjured shoulder depresses the shoulder of the injured side preventing
superimposition.
Patient’s midcoronal region should be 90° .Injured arm should be in relax position.
Humerus is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal so that central ray should pass through middle of the humerus.
EXPOSURE FACTOR
KV = 55-60. MA = 100
MAS = 15-20. FFD = 90 CM Collimated
SHOULDER AP VIEW
AIM
This view should demonstrate the bones and soft tissue of the shoulder.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying supine position over the X ray Couch.
Affected side arm and forearm are extended and abducted.
12 x 10 Cassette placed under the Shoulder joint including medial end of clavicle.
Unaffected side is slightly raised so that the affected side contact the Cassette.
. Head is rotated towards the unaffected side.
Shoulder is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through head of the humerus.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( SUPERIOR TO INFERIOR )
AIM
This view should demonstrate the bones and soft tissue of the shoulder, glenoid fossa, proximal end of humerus, acromioclavicular joint, outer
surface of coracoid process.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient seated sideways near the X ray Couch.
Affected shoulder is placed on the X ray couch and elbow is flexed.
12 x 10 Cassette placed under the Shoulder joint.
OFD ( Object to Film Distance) is reduced.
. Cassette is adjusted so that the head is the humerus and glenoid cavity is included.
Shoulder is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through head of the humerus.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( INFERIOR TO SUPERIOR )
AIM

This view should demonstrate the bones and soft tissue of the shoulder, glenoid fossa, proximal end of humerus, acromioclavicular joint, outer surface o
coracoid process.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient lying supine position over the X ray Couch.

Affected arm and forearm are extended and abducted.
Affected shoulder is raised and the position is maintained with the help of pillow.
12 x 10 Cassette is placed on the superior side of the Shoulder. Cassette is adjusted including the head of the humerus.
Head is rotated towards the unaffected side.
Shoulder is immobilized.
CENTERING OF X RAY TUBE
Tube is Horizontal and minimal angulation so that central ray should pass through Axilla.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( STRYKERS VIEW )
AIM

This view should demonstrate the bones and soft tissue of the shoulder and the posterosuperior and posterolateral areas of the humeral head. It is
sometimes useful in identifying the cause of shoulder dislocation including dislocations caused by posterior defects.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION

Patient lying supine position over the X ray Couch.

Affected arm and forearm are flexed and the palm of the hand touches the back side of the head.
12 x 10 Cassette is placed under the Shoulder including glenoid cavity and the head of the humerus.
Head is rotated towards the unaffected side.
Shoulder is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 10-15° so that central ray should pass through Axilla.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( CLEMENTS METHOD )
AIM

This view should demonstrate the bones and soft tissue of the shoulder, glenoid fossa, proximal end of humerus, acromioclavicular joint, outer
surface of coracoid process.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION
Patient lying lateral position over the X ray Couch.
Unaffected side should contact the couch.
12 x 10 Cassette placed on the superior side of the shoulder including the head of the humerus.
Affected side arm and forearm is extended and abducted 90°.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal so that central ray should pass through Axilla.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( WEST POINT METHOD )
AIM

To demonstrate the anterior aspect of glenoid rim and is useful for detecting bankart lesions.

GENERAL INSTRUCTIONS

Patient to remove the radiopaque metals.

PATIENT POSITION
Patient lying Prone position over the X ray Couch.
Affected side shoulder is raised with the help of pillow.
12 x 10 Cassette placed on the superior side of the shoulder including the head of the humerus.
Affected side arm and forearm is extended and abducted 90°.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal and tilted 25 °cranially ( towards head ) and 25° medially so that central ray should pass through Midscapulohumeral
joint.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( RAFFERT METHOD )
AIM
To view the Posterolateral humeral head and Hill Sachs lesion.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Supine position over the X ray Couch.
Affected shoulder is raised with the help of pillow.
12 x 10 Cassette placed on the superior side of the shoulder including the head of the humerus and glenoid cavity.
Affected side arm and forearm is extended and abducted 90°.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal and tilted 15-20° medially so that central ray should pass through acromioclavicular joint.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( GRAYSHEY METHOD )
AIM
To view the Joint space between Humeral head and glenoid cavity.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand upright position near the Chest stand.
12 x 10 Cassette placed chest stand upper border above the shoulder lower border below Scapula.
Unaffected side raised 45° so that affected side head of the humerus contact the Cassette.
The arm is rotated internally and the palm of the hand touches the abdomen.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal so that central ray should pass through glenoid fossa.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( GARTH METHOD )
AIM
To view the Glenoid cavity and Scapulohumeral joint.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand upright position near the Chest stand.
12 x 10 Cassette placed chest stand upper border above the shoulder lower border below Scapula.
Unaffected side raised 45° so that affected side shoulder contact the Cassette.
The arm is rotated internally and the palm of the hand touches the abdomen.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal and tilted 45 ° caudally so that central ray should pass through Scapulohumeral Articulation.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( INTERTUBERCULAR GROOVE )
AIM
To view the Bicipital Groove free of superimposition of shoulder joint.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand near the edge of the X ray couch.
Posterior aspect of the affected side forearm is placed over the X ray couch
12 x 10 Cassette is placed over the anterior surface of the forearm.
Humerus is flexed 10-15° so that the shoulder joint will be at the top of the Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through intertubercular groove.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( VALPEAU VIEW )
AIM
This projection is performed on patients with a shoulder sling (Velpeau bandage) in place, often in the context of post-operative or a post-
reduction presentation whereby the patient is unable to abduct the arm. It is particularly useful in the diagnosis of posterior shoulder dislocations.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand backward near the edge of the X ray couch.
10 x 8 Cassette placed near the edge of the X ray couch behind the patient.
Patient to bend backward 30° towards the table.
Cassette is adjusted so that glenoid cavity and head of the humerus are included.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through Glenohumeral joint.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
CLAVICLE AP VIEW
AIM
To view the tumor progression or multiple cancers.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Supine position over the X ray Couch.
Affected side forearm and arm is extended and abducted.
12 x 10 Cassette placed under the clavicle including medial and lateral end of the clavicle.
Unaffected side is slightly raised so that affected side contact Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between medial and lateral end of the clavicle.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
CLAVICLE PA VIEW
AIM
To view the tumor progression or multiple cancers.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand in erect position near the Chest stand.
Affected side forearm and arm is extended and abducted.
12 x 10 Cassette placed on the chest stand upper border above shoulder and lower border below scapula.
Unaffected side is slightly raised so that affected side contact Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal so that central ray should pass through middle of the Scapula.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
CLAVICLE INFERIOR TO SUPERIOR VIEW
AIM
To view the delineate fracture displacement, fractures to the medial clavicle.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying supine position over the X ray couch.
Affected side forearm and arm is extended and abducted.
12 x 10 Cassette placed under the clavicle with 20 ° angulation and the position is maintained by pillow.
Cassette is adjusted including medial and lateral end of clavicle.
Unaffected side is slightly raised so that affected side contact Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 45 ° Cranially ( towards head ) so that central ray should pass through middle of the middle of the clavicle.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
ACROMIOCLAVICULAR JOINT AP VIEW
AIM
To examine the suspected Acromioclavicular joint injury.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand upright position near the Chest stand.
12 x 10 Cassette placed chest stand upper border above the shoulder lower border below Scapula.
Shoulder joint must make contact with the cassette.
Patient’s arm should be in neutral position.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through Acromioclavicular joint.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
ACROMIOCLAVICULAR JOINT STRESS VIEW
AIM
This view is used in the assessment of possible acromioclavicular joint separation and may be done bilaterally to allow comparison of joint
spaces between the affected and unaffected side.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand upright position near the Chest stand.
12 x 10 Cassette placed chest stand upper border above the shoulder lower border below Scapula.
Shoulder joint must make contact with the cassette.
Patient’s arm should be in neutral position.
Patient to hold 5 kg sandbag on the affected side.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through Acromioclavicular joint.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
ACROMIOCLAVICULAR JOINT AXIAL VIEW ( ZANCA VIEW )
AIM
To examine the suspected Acromioclavicular subluxation or dislocation.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand upright position near the Chest stand.
12 x 10 Cassette placed chest stand upper border above the shoulder lower border below Scapula.
Shoulder joint must make contact with the cassette.
Patient’s arm can be put down completely.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal and tilted 10 -15 ° Cranially ( towards head ) so that central ray should pass through Coracoid Process.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
STERNOCLAVICULAR JOINT PA VIEW
AIM
To demonstrate sternoclavicular joint dislocation or medial end clavicular fractures
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying prone position over the X ray couch.
12 x 10 Cassette placed under the clavicle including medial end of the clavicle.
Cassette is adjusted so that sternoclavicular joint is in the middle of the Cassette
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through T3-T4.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
STERNOCLAVICULAR JOINT OBLIQUE VIEW
AIM
To demonstrate sternoclavicular joint dislocation or medial end clavicular fractures
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying prone position over the X ray couch.
12 x 10 Cassette placed under the clavicle including medial end of the clavicle.
Patient rotated towards unaffected side 10-15° and the position is maintained.
Cassette is adjusted so that sternoclavicular joint is in the middle of the Cassette
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through T3-T4
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
STERNOCLAVICULAR JOINT
SERENDIPITY VIEW OR ROCKWOOD VIEW
AIM
To demonstrate sternoclavicular joint dislocation or medial end clavicular fractures
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Supine position over the X ray couch.
12 x 10 Cassette placed under the clavicle including medial end of the clavicle.
Upper limbs are extended.
Cassette is adjusted so that sternoclavicular joint is in the middle of the Cassette
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 40° Cranially ( towards head ) so that central ray should pass through T3-T4
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SCAPULA AP VIEW
AIM
To diagnose and monitor the scapula fractures .
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Supine position over the X ray Couch.
Affected side forearm and arm is extended and abducted.
10 x 8 Cassette placed under the scapula upper border above shoulder and lower border below scapula.
Unaffected side is slightly raised so that affected side contact Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through middle of scapula.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SCAPULA Y VIEW
AIM
To view the suspected Shoulder dislocations.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Prone position over the X ray Couch.
Affected side arm is abducted and the elbow is flexed and dorsal surface of hand touches the back side of waist.
12 x 10 Cassette placed Bucky.
Cassette is adjusted upper border above shoulder and lower border below scapula.
Unaffected side is raised 45 °so that affected side contact Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through middle of scapula.
EXPOSURE FACTOR
KV = 60-65. MA = 200
MAS = 50-60. FFD = 90 CM Collimated