Shoulder radiologic anatomy

Shoulder radioanatomy

Dr. Henock.N

Shoulder girdle

Shoulder girdle

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Scapula

-flat,∆ bone-inferior angles lies ~ over lower border of 7th rib post (guide)4 main processes

Cont…

Clavicle

• S shaped, broad medial & lat. Ends.

• Diarthroidal Sternoclav & Synovial AC joints,

• Costoclav. (rhomboid) coracoclavicular & coracoacromial ligaments

Cont…

Cont…

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Shoulder joint anatomy

• Humeral bone & GF • Glenoid fossa

shallow,covers1/3rdof hum. Head • Stability; Glenoid labrum (Fibro

Capsular (cartilageneous) ring deepen to the GF)

• Capsule is thickened ant. by ‘3 Glenohumeral ligaments

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Shoulder Joint views

• AP view, external & internal rotation• Axillary view • Trans-scapular Y view • Posterior oblique view (Grashey view)

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3.Posterior oblique view (GH Joint seen tangentially)

• Position; pt erect turned 30-35 deg to ward ‘side being x-rayed

• Tube; perpendicular to plate• Evaluate: humeral head

position relative to glenoid, • Posterior dislocation

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Clavicular view

• AP • Angled view of ‘clavicle • Serendipity view- demonstrates Sternoclavicuar Joint (SCJ)

helpful for dislocation Supine with cassette under upper chest. Beam aimed at

clavicle or manibruim with 40 deg cephalad tilt

Cont…

Radiographically, ‘clavicles are always demonstrated on ‘frontal CXR: their medial ends are projected over ‘posterior aspect of ‘4th rib

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Acromioclavicular joint

• Complex synovial joint b/n Clavicle & Acromion• ‘Conoid & trapezoid ligaments( together→

coracoclavicular ligament ) provide ‘principal stability of ‘joint

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Imaging of AC joint

• Specific views for AC joints1. 30 deg. tube angled cephalad (demonstrate joint enface) 2. 30 deg. angled caudally (demonstrates it tangent)

Plays a crucial role in ‘DX of tendinous lesions Provide valuable information about bony contours & tendon calcification

Acromio-humeral space- <5mm is indicative of tear in ‘supraspinatus tendon.

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Inferior cortex of the clavicle should align with the inferior cortex of the acromion

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Conoid tubercle

Superior angle of the scapula

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AC joint space 3-8mm

The distance b/n coracoid process & clavicle should be 10-13mm

Thank u !