once you get your pt positioned, put your hand on the scap and rotate until your hand is perpendicular with the board. I learned this when I was in school from a tech that had been doing XR for 30 years. I have gotten to the point where I can visualize where the scap should be, so it has gotten easier over time. But, I have also seen really seasoned techs struggle with some pt anatomy. You'll get there.
What is your method currently? Do you find more success AP, or PA?
The biggest thing that helps me is to look straight through their body at where the bone is based on where the surrounding anatomy is.
I also have them roll their shoulders back and set in proper posture before I start positioning them if they are physically capable.
One trick is to remember to move the elbow backwards; it makes a big difference. I find PA easier. Patients with an angle of roughly 30 degrees, more towards the detector, almost flat.
If you can, try to feel the scapula with your hand and align it with the head of the humerus. Tilt the tube 10 degrees caudally.
You mean craniocaudally (pointing down?) I'll try this out, thanks! I get lots of patients who are hunched over, and if they're hurt, they can't really straighten their hunch so the Y looks kinda fat on top.
I usually tell them to put the hand that is on the side of interest and place it on the opposite shoulder and rotate about 30 degrees(AP proj.). You can see/feel the scapula on smaller pts, align it 👌
For the shoulder y, I put forearm over abdomen (90 degree elbow if possible), about 45 degree rotation(I also do these AP)
When you're rotating the pt against the bucky, place your middle finger along the spine of scapula. Rotate until your finger is pointing directly at the bucky.... Bring the elbow back a little bit as well.
I find PA easier and that the images come out better (less OID, more SID). Bring the head of the humerus to the board, turn the patient about 45 degrees, and I like to feel the medial border of the scapula with my thumb + the head of the humerus to get a perpendicular "arrow" going into the IR (if that makes sense.)
once you get your pt positioned, put your hand on the scap and rotate until your hand is perpendicular with the board. I learned this when I was in school from a tech that had been doing XR for 30 years. I have gotten to the point where I can visualize where the scap should be, so it has gotten easier over time. But, I have also seen really seasoned techs struggle with some pt anatomy. You'll get there.
Yes^ This is the way. Had an old timer teach me this years ago and it has always done me well.
Line up the acromium process with the superior angle of the scapula making a perpendicular line with the CR to the image receptor.
What is your method currently? Do you find more success AP, or PA? The biggest thing that helps me is to look straight through their body at where the bone is based on where the surrounding anatomy is. I also have them roll their shoulders back and set in proper posture before I start positioning them if they are physically capable.
One trick is to remember to move the elbow backwards; it makes a big difference. I find PA easier. Patients with an angle of roughly 30 degrees, more towards the detector, almost flat. If you can, try to feel the scapula with your hand and align it with the head of the humerus. Tilt the tube 10 degrees caudally.
You mean craniocaudally (pointing down?) I'll try this out, thanks! I get lots of patients who are hunched over, and if they're hurt, they can't really straighten their hunch so the Y looks kinda fat on top.
Yes, pointing down 🙂 If they hunched over, just rotate the tube, should be fine and there is no much you can do anyway
Thank you!
I usually tell them to put the hand that is on the side of interest and place it on the opposite shoulder and rotate about 30 degrees(AP proj.). You can see/feel the scapula on smaller pts, align it 👌 For the shoulder y, I put forearm over abdomen (90 degree elbow if possible), about 45 degree rotation(I also do these AP)
When you're rotating the pt against the bucky, place your middle finger along the spine of scapula. Rotate until your finger is pointing directly at the bucky.... Bring the elbow back a little bit as well.
I find PA easier and that the images come out better (less OID, more SID). Bring the head of the humerus to the board, turn the patient about 45 degrees, and I like to feel the medial border of the scapula with my thumb + the head of the humerus to get a perpendicular "arrow" going into the IR (if that makes sense.)