Shoulder - Neers

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Shoulder - Neers
Area Covered	"Out-let" view for area under coracoacromial arch or supraspinatus outlet, inlcudes humeral head, glenoid, acromion, lateral clavicle, superior scapula
Pathology shown	Spurs, calcifications, impingement on supraspinatus outlet, shape of acromion
Radiographic Anatomy	Shoulder Radiographic Anatomy
IR Size & Orientation	18cm x 24cm Portrait
Film / Screen Combination	Regular (CR and DR as recommended by manufacturer)
Bucky / Grid	Upright bucky
Filter	No
Exposure	75 kVp 25 mAs
FFD / SID	100cm
Central Ray	CR angled 10° to 15° caudal (to show supraspinatus outlet) Directed to exit at the superior part of the humeral head
Collimation	Centre: Superior part of medial border of scapula (to exit at superior portion of humeral head) Shutter A: Above acromion process and lateral clavicle Shutter B: Skin line
Markers	Lateral and superior Marker orientation is PA
Shielding	Gonadal (check your department's policy guidelines)
Respiration	Suspended
Positioning	Patient standing upright facing the bucky Arm straight at side or slightly abducted Rotate the patient so that the affected shoulder is toward the bucky Obliquity required is between 45° to 60° and depends on the patient The aim is to make the body of the scapula perpendicular to the bucky Centre so the acromion of the affected shoulder is in the middle of the bucky
Critique PACEMAN	Positioning Acromioclavicular joint should be in the midline Humeral head directly below acromioclavicular joint Correct obliquity of the patient is evidenced by The body of the scapula is in a lateral position (shown by super-imposition of the medial and lateral borders of the body of the scapula) Body of the scapula, acromion and coracoid processes form a "Y" with the glenoid at its convergen (see note below) Correct central ray angulation is evidenced by Clear view through the supraspinatus outlet, beneath the coracoacromial arch (see note below) Area Covered Clear supraspinatus outlet, acromioclavicular joint, humeral head, superior scapula in a lateral position Collimation Centre: Humeral head Shutter A: Above acromion process and lateral clavicle Shutter B: Skin-line Exposure Bony trabecular patterns and cortical outlines are sharply defined Soft tissues are visualised
Special Notes	Detecting incorrect obliquity Detecting incorrect central ray angulation