Radiography: shoulder

• Accurate centering is essential when radiographing any joint.
• High definition film-screen combinations are required.
• A grid is not necessary.
• kV should not exceed about 50.
• Close collimation is essential.
• General anesthesia or heavy sedation is needed.
• The film must include the whole joint, with soft tissues, must be correctly exposed and developed and free from movement blur and artifact.
• The anatomical marker must be clearly visible, along with the patient's identification, the date, and the name of the hospital or practice.
  Print off the Owner factsheet on Xray and Ultrasound to give to your clients.

Uses

• An important diagnostic aid in determining the cause of a lameness arising from the shoulder.
• Bony injury: fracture Limb fracture or dislocation.
• Bony neoplasia or soft tissue neoplasia invading bone.
• Investigation of soft tissue injury.
• Joint effusion, swelling.
• Arthritis Arthritis.
• Osteomyelitis Osteomyelitis.

Advantages

• Non-invasive.
• Straightforward.

Disadvantages

• Poor positioning can make subtle pathology impossible to detect.
• The presence of severe pain can make the procedure difficult in a conscious patient.

Time required

Preparation

• Dependent upon the method of chemical restraint (GA or sedation).

Procedure

• 10-15 min, or longer, dependent upon skill of radiographer.

Decision taking

Criteria for choosing test

Is the examination appropriate?

• Can you make the diagnosis without it?
• Can it tell you what you need to know?
• Will your management be affected by the radiological findings?

Choosing the right projections

Lateral: standard projection

• Shows joint space and head of humerus .
• Shows soft tissue swelling and joint effusions.
• Can show calcification in tendons and osteoarthritis.

Craniocaudal: second standard projection or supplementary

• Essential second view in cases of known or suspected fracture .
• Usually necessary in cases of dislocation.