Humerus – shaft

Humerus – shaft

Position of patient and image receptor

• A 35 × 43 cm CR cassette is positioned in an erect cassette holder or alternatively a vertical DDR receptor is selected.
• The patient sits or stands with their back in contact with the image receptor.
• The patient is rotated towards the affected side to bring the posterior aspect of the shoulder, upper arm, and elbow into contact with the image receptor.
• The patient’s position is adjusted to ensure that the medial and lateral epicondyles of the humerus are equidistant from the receptor.
• The forearm maybe immobilized using a sandbag.

Direction and location of X-ray beam

• The vertical collimated X-ray beam is centred to a point midway between the shoulder and elbow joints at rightangles to the image receptor.

Lateral – erect

Position of patient and image receptor

• A 35 × 43 cm CR cassette is positioned in an erect cassette holder or a vertical DDR receptor is selected.
• From the anterior position, the elbow joint is flexed to 90°.

the patient is rotated through 90° until the lateral aspect of the injured arm is in contact with the image receptor.

• The patient is rotated further until the arm is clear of the rib cage but still in contact with the image receptor.

Direction and location of X-ray beam

• The horizontal collimated X-ray beam is centred to a point midway between the shoulder and elbow joints at right angles to the shaft.

Essential image characteristics

• The exposure should be optimised to ensure that the area of interest is clearly visualised.

Positioning the patient supine allows greater stability than positioning the patient standing.

Position of patient and image receptor

• The patient lies supine on the X-ray table, with the unaffected side raised and supported on pads.
• A 35 × 43 cm CR cassette is positioned under the affected limb and adjusted to include the shoulder and elbow joints

Humerus – shaft

• The arm is slightly abducted and the elbow joint is full extended, so that the posterior aspect of the upper arm is in contact with the image receptor.
• The arm is adjusted to ensure that the medial and lateral epicondyles are equidistant from the image detector.
• The forearm may be immobilised using a sandbag.

Lateral – supine

• Position of patient and image receptor
• From the antero-posterior position, the elbow joint is flexed to 90°.
• The arm is abducted and then medially rotated through 90° to bring the medial aspect of the arm, elbow and forearm in contact with the table.
• A 35 × 43 cm CR cassette is placed under the arm and adjusted to include both the shoulder and the elbow joints.
• The humerus is adjusted to ensure that the medial and lateral epicondyles of the humerus are superimposed.
• The forearm may be immobilised using a sandbag.

Direction and location of X-ray beam

• The vertical collimated X-ray beam is centred to a point midway between the shoulder and elbow joints.

Essential image characteristics

• Both joints should be seen on the image.
• The elbow joint should be seen in the true lateral and antero-posterior positions.

Radiation protection/dose

• Careful technique and close collimation will assist in reducing the patient dose.