Shoulder radiologic anatomy
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Henock Negasi ( MD) radiology resident ayder specialized hospital, mekelle university
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Shoulder radiologic anatomy
- 4. Scapula -flat,∆ bone -inferior angles lies ~ over lower border of 7th rib post (guide) 4 main processes 4
- 5. Cont…
- 6. Clavicle • S shaped, broad medial & lat. Ends. • Diarthroidal Sternoclav & Synovial AC joints, • Costoclav. (rhomboid) coracoclavicular & coracoacromial ligaments
- 7. Cont…
- 9. Cont…
- 12. 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 12
- 13. Shoulder Joint views • AP view, external & internal rotation • Axillary view • Trans-scapular Y view • Posterior oblique view (Grashey view) 13
- 18. 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 18
- 24. 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 24
- 25. Cont… Radiographically, ‘clavicles are always demonstrated on ‘frontal CXR: their medial ends are projected over ‘posterior aspect of ‘4th rib
- 26. Acromioclavicular joint • Complex synovial joint b/n Clavicle & Acromion • ‘Conoid & trapezoid ligaments( together→ coracoclavicular ligament ) provide ‘principal stability of ‘joint 26
- 27. Imaging of AC joint • Specific views for AC joints 1. 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. 27
- 28. 28 Inferior cortex of the clavicle should align with the inferior cortex of the acromion
- 29. 29 Conoid tubercle Superior angle of the scapula
- 30. 30 AC joint space 3-8mm The distance b/n coracoid process & clavicle should be 10-13mm
- 31. Thank u !
Editor's Notes
- -flat,∆ bone -med. &lat margin -concave costal & convex dorsal surface -body (blade)from w/h glenoid fossa & CP project laterally -spine project post (SSF/ISF),cont. lat to form Acromion P -inferior angles lies ~ over lower border of 7th rib post (guide)
- ’Rhomboid ligament (costoclavicular ligament) is attached to ‘inferomedial aspect of ‘clavice & inserts in to ‘1st costal cartilage. In ~ 5 % of individuals, an irregular groove in ‘clavicle, termed ‘rhombiod fossa, is present at ‘site of origin of ‘rhomboid ligament & should not be mistaken for a pathological entity. Lateral end provide a surface to articulate with ‘acromion process at ‘AC joint. Two further ligaments- ‘Conoid (medially) & trapezoid (laterally) take origin from ‘inferior aspect of ‘clavicle.
- , shoulder j is attached proximally to ‘glenoid labrum,w/h is fibrocartilagenous ring that deepens the glenoid fossa, & distally to ‘anatomic neck of ‘humerus, encroching inferiorly on the neck of bone, The effects of fibrocartilegenous ring is to enlarge ‘articular surface by ⅔
- Grashey view?