Radiographic Positions and Projections Upper Limb
Transthoracic Lateral Shoulder
CR entering the mid coronal plane at the surgical neck W/O ability to elevate arm, angle CR 10-15 degrees cephalic Full inspiration Proximal humerus is projected in the thorax
Axial Trauma (Coyle)
CR horizontal directed 45degrees cephalad to the visualize the radial head CR horizontal directed 45 degrees caudad to visualize the coronoid process
Inferosuperior Axial Shoulder
CR horizontally through the axilla Degree of medial angulation 15-30 degrees Humerus externally rotated Exaggerated external rotation (Rafert Method) Lesser tubercle in profile and coracoid process directed anteriorly
AP Clavicle
CR midshaft of clavicle Suspend respiration at the end of exhalation
Lateral Thumb
CR perpendicular to 1st MCP Concave, anterior surface of proximal phalanx
Oblique Thumb
CR perpendicular to 1st MCP Proper rotation of phalanges
AP Thumb
CR perpendicular to 1st MCP joint Patient's hand in extreme medial rotation
Lateral Hand
CR perpendicular to 2nd MCP
Oblique Hand
CR perpendicular to 3rd MCP
PA Hand
CR perpendicular to 3rd MCP
AP Neutral Shoulder
CR perpendicular to a point 1 inch inferior to the coracoid process Palm of hand placed against hip Epicondyles at a 45degree angle Posterior part of the supraspinatus insertion is visualized
AP Internal Shoulder
CR perpendicular to a point 1 inch inferior to the coracoid process Rotate arm internally Rest back of hand on hip Epicondyles perpendicular Suspend respiration
AP External Shoulder
CR perpendicular to a point 1 inch inferior to the coracoid process Supinate the hand Humeral head in profile Greater tubercle and site of insertion of the supraspinatus tendon are visualized
Internal Oblique Elbow
CR perpendicular to elbow joint Coronoid process in profile Hand Pronated
External Oblique Elbow
CR perpendicular to elbow joint Radial head, neck and tuberosity projected free of ulna Hand supinated
Lateral Elbow
CR perpendicular to elbow joint Superimposed humeral condyles Olecranon process in profile
AP Partial Flexion
CR perpendicular to elbow joint and proximal forearm
AP Humerus
CR perpendicular to mid portion of humerus Top of IR 1 1/2 inches above the head of humerus Humeral head and greater tubercle in profile
PA Wrist
CR perpendicular to midcarpal area
Oblique Wrist
CR perpendicular to midcarpal area; enters just distal to radius Well shown trapezium and distal half of scaphoid
Lateral Forearm
CR perpendicular to midpoint of forearm
AP Forearm
CR perpendicular to midpoint of forearm Well shown wrist and distal humerus Hand supinated
PA for Scaphoid
CR perpendicular to scaphoid Well shown scaphoid with adjacent articulations
PA Finger
CR perpendicular to the PIP joint
Finger lateral
CR perpendicular to the PIP of the affected digit
Oblique Finger
CR perpendicular to the PIP of the affected digit Rotate hand laterally on a 45degree foam wedge
AP Elbow
CR perpendicular to the elbow joint
Lateral PO Scapula
CR perpendicular to the lateral border of the rib cage at the mid scapular area Patient turns away from affected side rotating the shoulder 15-20degrees Suspend respiration
Lateral AO Scapula
CR perpendicular to the mid-medial border of protruding scapula 45-60degree rotation from the plane of the IR
Scapular Y Shoulder
CR perpendicular to the scapulohumeral joint Unaffected side 45-60degrees Suspend Respiration Humeral shaft and scapular body superimposed Acromion projected laterally
Lateral Wrist
CR perpendicular to wrist joint Well shown distal radius & ulna , carpals & proximal half of metacarpals
Scaphoid Stecher (PA Axial)
CR directed to enter scaphoid IR angled 20degrees
Carpal Canal (Gaynor Hart Method)
CR directed to palm of the hand 1" distal to the 3rd MC CR angled 25-30degrees Shows all carpals with pisiform in profile Hamulus of hamate
Tangential Shoulder
CR 10-15 degrees caudad entering superior aspect of humeral head Suspend Respiration Humeral head projected below the AC joint
Transthoracic Lateral Humerus
CR 10-15 degrees cephalad Opposite arm and shoulder raised Affected arm dropped
AP Scapula
CR 2inches inferior to the coracoid process Exposure made during slow breathing
Posterior Oblique Shoulder Grashey
CR 2inches medial and 2inches inferior to the superolater border of the shoulder Rotate body 35-45 degrees toward affected side Suspend respiration Scapulohumeral joint shown
PA Axial Clavicle
CR angled 15-30degrees caudad
AP Axial Clavicle
CR angled 15-30degrees cephalad (supine) CR angled 0-15 degrees cephalad (standing lordotic)
Acromioclavicular Joints -AP Biateral w/&w/o weights
CR at level of AC joints Suspend Respiration
AP Neutral Humerus
Seated or standing Humeral head and greater tubercle in profile
Lateral Humerus
Superimposed epicondyles Lesser tubercle in profile
