Clavicle - AP shoulder

Radiographic Positioning

Adult

Other related pages of interest Applied Radiography Radiographic Anatomy Radiographic Protocols

Name of projection	Clavicle - AP
Area Covered	Entire clavicle, acromioclavicular joint, sternoclavicular joint
Pathology shown	Fractures and dislocations
Radiographic Anatomy	Shoulder Radiographic Anatomy
IR Size & Orientation	24cm x 30 cm Landscape
Film / Screen Combination	Regular (CR and DR as recommended by manufacturer)
Bucky / Grid	Moving or stationary grid, no grid for children
Filter	Using the shoulder filter is optional
Exposure	65 kVp 16 mAs
FFD / SID	100cm
Central Ray	Directed to mid-clavicle Perpendicular to IR
Collimation	Centre: Palpate both ends of the clavicle and direct the central ray half-way between Shutter A: Include the jugular notch to beyond the acromio-clavicular joint Shutter B: To include the entire clavicle
Markers	Lateral/Superior Marker orientation is AP
Shielding	Gonadal (check your department's policy guidelines)
Respiration	Not applicable Inspiration may aide in elevating the clavicle
Positioning	Patient stands erect with back to upright bucky (can do supine) Make sure they are standing up straight and not slouching Arms at sides Chin raised Eyes looking straight ahead Posterior aspect of shoulder to the upright bucky Ensure both shoulders are equal in distance from the upright bucky Centre the light field to the clavicle Centre the IR
Critique PACEMAN	Positioning No rotation of patients shoulders is evidenced by: The clavicle exhibits no longitudinal foreshortening The sternal end of the clavicle lies next to the vertebral column Patient's torso is upright (upper mid-coronal plane is vertical), is evidenced by: The clavicle exhibits no inferosuperior foreshortening The middle of the clavicle is super-imposed on the superior scapula angle Area Covered Entire clavicle, acromioclavicular joint, sternoclavicular joint Collimation Centre: Palpate both ends of the clavicle and direct the central ray half-way between Shutter A: Include the jugular notch to beyond the acromio-clavicular joint Shutter B: To include the entire clavicle Exposure Bony trabeculation and cortical outlines of the clavicle are sharply defined Soft tissues are visualised
Special Notes	Note: This projection can also be done PA if neccessary for patient comfort. It also puts the clavicle closer to the IR Determing direction of rotation of patients shoulders If the sternal end of the clavicle is positioned over the vertebral column, the affected side is further away from the IR Determining direction of tilt of patients upper mid-coronal plane (that is the patient is tilting forward or backward) The middle of the clavicle should be super-imposed over the superior angle of the scapula If the superior angle of the scapula is projected superiorly to the mid-clavicle the patient is leaning forward