- Fracture of the scapula are demonstrated.
Technical Factors:
- IR size - 24 x 30 cm (10 x 12 inches), lengthwise
- Moving or stationary grid
- 75 +- 5 kV range
- Minimum of 3 seconds exposure time with breathing technique (3 to 4 seconds is desirable)
- Manual exposure factors (AEC is not recommended)
Shielding:
- Place gonadal shield over pelvic area.
Patient Position:- Perform radiograph with the patient in an erect or supine position. (The erect position may be more comfortable for the patient.) Posterior surface of shoulder is in direct contact with tabletop or IR without of thorax. (Rotation towards affected side would place scapula into a truer posterior position, but this also would result in greater superimposition of the rib cage.)
Part Position:
- Position patient so midscapula area is centered to CR.
- Adjust cassette to center to CR. Top of IR should be about 2 inches (5 cm) above shoulder, and lateral border of IR should be about 2 inches (5 cm) from lateral margin of rib cage.
- Gently abduct arm 90 degree and supinate hand. (Abduction will move scapula laterally to clear more of the thoracic structures.)
Central Ray:
- CR perpendicular to midscapula, 2 inches (5 cm) inferior to caracoid process, or to level of axilla, and approximately 2 inches (5 cm) medial from lateral border of patient
- Minimum SID of 40 inches (100 cm)
Collimation:
- Collimate on four sides to area of scapula.
Respiration:
- Breathing technique is preferred if patient can cooperate. Ask patient to breathe gently without moving affected shoulder or arm.
Radiographic Criteria:
Structure Shown:
- The lateral portion of the scapula is free of superimposition.
- The medial portion of the scapula is seen through the thoracic structures.
Position:
- Affected arm seen to be abducted 90 degrees and hand supinated, as evidenced by the lateral border of the scapula free of superimposition.
Collimation and CR:
- Collimation should be visible on four sides to the area of the affected scapula.
- CR and center of the collimation field should be at midscapula area.
Exposure Criteria:
- Optimal density and contrast with no motion will demonstrate clear, sharp bony trabecular markings of the lateral portion of the scapula. Ribs and lung structures will appear blurred with breathing technique.
