The document provides a detailed overview of the radiographic anatomy of the upper limb, including the bones and joints. It describes the key anatomical features of the clavicle, scapula, humerus, radius, ulna, carpals, metacarpals, and phalanges. It also discusses the shoulder joint, elbow joint, wrist joint, and hand. Evaluation criteria for obtaining proper radiographs of these structures in different projections are also outlined.

1. Radiographic Anatomy of Upper
Limb
Ms. Donisha K Johnson
M.Sc. Medical Technology Semester I
Imaging Sciences Specialization

3. CLAVICLE

6. • The clavicle is an elongated, S-shaped bone that rests horizontally at the sternum across the upper part
of the ribcage, and the acromial end of the scapula.
• This bone is an important part of the skeletal system since it plays an essential role in everyday
functional movement, serving as the connection between the axial skeleton and the pectoral girdle.
• It acts a brace for the shoulder and allows the weight of the upper limbs to be transferred to the axial
skeleton
• Injury to the clavicle severely compromises on everyday activities
• the acromioclavicular joint, which is formed by the acromial end of the clavicle and the acromion of the
scapula respectively
• The other is the sternoclavicular joint, which is formed by the sternal end of the clavicle and
the manubrium of the sternum

14. SCAPULA

16. • The scapula, classified as a flat bone, forms the posterior part of the shoulder girdle
• Triangular in shape, the scapula has two surfaces, three borders, and three angles.
• Lying on the supero-posterior thorax between the second and seventh ribs
• The costal (anterior) surface of the scapula is slightly concave and contains the subscapular fossa
• The dorsal (posterior) surface is divided into two portions by a prominent spinous process.
• The crest of the spine runs obliquely superior to end into a small flattened ovoid projection called the acromion
• The superior border extends from the superior angle to the coracoid process and at its lateral end has a deep
depression, the scapular notch
• The lateral angle, the thickest part of the body of the scapula, ends in a shallow, oval depression called the
glenoid cavity. The constricted region around the glenoid

20. SHOULDER JOINT

21. •The shoulder girdle is formed by two bones—the clavicle and the
scapula. The function of these bones is to connect the upper limb to
the trunk.
•The girdle is completed in front by the manubrium of the sternum,
which articulates with the medial end of the clavicle.
•Joints of the shoulder girdle are – AC joint, SC Joint &
glenohumeral joint

26. HUMERUS
•The humerus is the longest and largest bone of the upper limb. It consists of a
proximal end, a shaft and a distal end, all which contain important
anatomical landmarks.
•The humerus articulates with the scapula proximally at the glenohumeral
joint so it participates in the movements of the shoulder. Also, the humerus
has distal articulations with the radius and ulna at the elbow joint.

30. Evaluation criteria for AP View
• ■ Evidence of proper collimation
• ■ Elbow and shoulder joints
• ■ Maximal visibility of epicondyles without rotation
• ■ Humeral head and greater tubercle in profile
• ■ Outline of the lesser tubercle, located between the humeral head and the greater tubercle
• ■ Similar image brightness and contrast of the proximal and distal humerus
• ■ Soft tissue and bony trabecular detail

32. Evaluation criteria for Lateral View
■Evidence of proper collimation
■ Elbow and shoulder joints
■ Superimposed epicondyles
■ Lesser tubercle in profile on medial aspect
■ Greater tubercle superimposed over the humeral head
■ Beam divergence resulting in distortion of the elbow joint
■ Similar image brightness and contrast of the proximal and distal humerus
■ Soft tissue and bony trabecular detail

36. ELBOW JOINT
• The elbow joint includes the proximal radioulnar articulation and the articulations
between the humerus and the radius and ulna.
• The three joints are enclosed in a common capsule. The trochlea of the humerus
articulates with the ulna at the trochlear notch.
• The capitulum of the humerus articulates with the flattened head of the radius.
• The humeroulnar and humeroradial articulations form a synovial hinge joint and
allow only flexion and extension movement

40. Evaluation Criteria AP View
Evidence of proper collimation
■ Radial head, neck, and tuberosity slightly superimposed over the
proximal ulna
■ Elbow joint open and centered to the central ray
■ No rotation of humeral epicondyles (coronoid and olecranon fossae
approximately equidistant to epicondyles)
■ Soft tissue and bony trabecular detail

42. Evaluation Criteria Lateral View
Evidence of proper collimation
■ Elbow joint open and centered to the central ray
■ Elbow in a true lateral position:
□ Superimposed humeral epicondyles
□ Radial tuberosity facing anteriorly
□ Radial head partially superimposing the coronoid process
□ Olecranon process in profile
■ Elbow flexed 90 degrees
■ Bony trabecular detail and any elevated fat pads in the soft tissue at the anterior and posterior distal
humerus and the anterior proximal forearm

45. FOREARM
• The forearm contains two bones that lie parallel to each other—the radius and the ulna.
• Similar to other long bones, they have a body and two articular extremities.
• The radius is located on the lateral side of the forearm, and the ulna is located on the medial
side

47. ULNA
• ULNA The body of the ulna is long and slender
• The upper portion of the ulna is large and presents two beaklike processes and concave depressions The
proximal process, or olecranon process, concaves anteriorly and forms the proximal portion of the
trochlear notch.
• The more distal coronoid process projects anteriorly from the anterior surface of the body and curves
slightly superiorly. The process is triangular and forms the lower portion of the trochlear notch.
• A depression called the radial notch is located on the lateral aspect of the coronoid process.
• The distal end of the ulna includes a rounded process on its lateral side called the head and a narrower
conic projection on the posteromedial side called the ulnar styloid process. An articular disk separates
the head of the ulna from the wrist joint

48. RADIUS
• The proximal end of the radius is small and presents a flat disklike head above a
constricted area called the neck.
• Just inferior to the neck on the medial side of the body of the radius is a
roughened process called the radial tuberosity.
• The distal end of the radius is broad and flattened and has a conic projection on
its lateral surface called the radial styloid process.

51. Evaluation Criteria AP View
■ Evidence of proper collimation
■ Entire forearm, including wrist and distal humerus
■ Slight superimposition of the radial head, neck, and tuberosity over the proximal ulna
■ No elongation or foreshortening of the humeral epicondyles
■ Partially open elbow joint if the shoulder was placed in the same plane as the forearm
■ Open radioulnar space
■ Similar image brightness and contrast of the proximal and distal forearm
■ Soft tissue and bony trabecular detail

53. Evaluation Criteria Lateral View
■ Evidence of proper collimation
■ Entire forearm, including wrist and distal humerus in a true lateral position: □
Superimposition of the radius and ulna at their distal end □ Superimposition of the radial
head over the coronoid process
□ Radial tuberosity facing anteriorly
□ Superimposed humeral epicondyles
■ Elbow flexed 90 degrees
■ Soft tissue and bony trabecular detail along the entire length of the radial and ulnar bodies

56. WRIST JOINT
• The wrist has eight carpal bones, which are fitted closely together and arranged
in two horizontal rows
• The proximal row of carpals, which is nearest the forearm, contains the scaphoid,
lunate, triquetrum, and pisiform. The distal row includes the trapezium,
trapezoid, capitate, and hamate

60. Evaluation Criteria for AP View
Evidence of proper collimation
■ Distal radius and ulna, carpals, and proximal half of metacarpals
■ No excessive flexion of digits to overlap and obscure metacarpals
■ No rotation in carpals, metacarpals, radius, and ulna
■ Open radioulnar joint space
■ Soft tissue and bony trabecular detail

62. Evaluation Criteria for Lateral View
Evidence of proper collimation
■ Distal radius and ulna, carpals, and proximal half of metacarpals
■ Superimposed distal radius and ulna
■ Superimposed metacarpals
■ Soft tissue and bony trabecular detail

65. HAND
• The hand consists of 27 bones, which are subdivided into the following groups:
• • Phalanges: Bones of the digits (fingers and thumb)
• • Metacarpals: Bones of the palm
• • Carpals: Bones of the wrist
• First digit (thumb)
• • Second digit (index finger)
• • Third digit (middle finger)
• • Fourth digit (ring finger)
• • Fifth digit (small finger)

67. PHALANGES
• The digits contain 14 phalanges (phalanx, singular), which are long bones that consist of a cylindrical body
and articular ends.
• Nine phalanges have two articular ends. The first digit has two phalanges— proximal and distal.
• The other digits have three phalanges—proximal, middle, and distal. The proximal phalanges are the
closest to the palm, and the distal phalanges are the farthest from the palm.
• The distal phalanges are small and flattened, with a roughened rim around their distal anterior end; this
gives them a spatula like appearance. Each phalanx has a head, body, and base.

68. METACARPALS
• Five metacarpals, which are cylindric in shape and slightly concave anteriorly, form the
palm of the hand
• They are long bones consisting of a body and two articular ends—the head distally and
the base proximally.
• The area below the head is the neck, where fractures often occur.
• The first metacarpal contains two small sesamoid bones on its palmar aspect
• The metacarpal heads, commonly known as the knuckles, are visible on the dorsal hand in
flexion

70. Evaluation Criteria for AP View
• Evidence of proper collimation
• ■ Anatomy from fingertips to distal radius and ulna
• ■ Slightly separate digits with no soft tissue overlap
• ■ No rotation of the hand
• □ Equal concavity of the metacarpal and phalangeal bodies on both sides
• □ Equal amount of soft tissue on both sides of the phalanges
• □ Fingernails, if visualized, in the center of each distal phalanx
• □ Equal distance between the metacarpal heads
• ■ Open MCP and IP joints, indicating that the hand is placed flat on the IR ■ Soft tissue and bony
trabecular detail

72. Evaluation Criteria for Oblique View
• Evidence of proper collimation
Anatomy from fingertips to distal radius and ulna
■ Digits separated slightly with no overlap of their soft tissues
■ 45 degrees of rotation of anatomy
□ Minimal overlap of the third, fourth, and fifth metacarpal bodies
□ Slight overlap of the metacarpal bases and heads
□ Separation of the second and third metacarpals
■ Open IP and MCP joints
■ Soft tissue and bony trabecular detail

75. Evaluation Criteria for Lateral View
• Evidence of proper collimation
• ■ Anatomy from fingertips to distal radius and ulna
• ■ Extended digits
• ■ Hand in a true lateral position
• □ Superimposed phalanges (individually seen on fan lateral)
• □ Superimposed metacarpals
• □ Superimposed distal radius and ulna
• ■ Thumb free of motion and superimposition
• ■ Soft tissue and bony trabecular detail