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Humerus Projections

Upper Extremities X-ray positioning guide.

Humerus Projections
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Humerus Projections

Patient Preparation

  • Explain the procedure to the patient.
  • Remove any jewelry or metallic objects from the arm.
  • Position the patient comfortably at the table or standing.
  • Use lead shielding as appropriate.

BASIC PROJECTIONS

1. Anteroposterior (AP) Projection — Humerus

Positioning:

  • Patient standing or supine.
  • Arm extended, supinated if possible.
  • Shoulder and elbow in the same plane.
  • Epicondyles parallel to IR.

Central Ray (CR):

  • Perpendicular to IR.
  • Directed to mid-humerus.

SID:

  • 100–110 cm (40–44 inches).

Collimation:

  • Include shoulder joint superiorly and elbow joint inferiorly.

2. Lateral Projection — Humerus

Positioning:

  • Patient standing or supine.
  • Flex elbow 90° if possible.
  • Rotate arm so epicondyles perpendicular to IR.
  • Humerus in true lateral alignment.

Central Ray (CR):

  • Perpendicular to IR.
  • Directed to mid-humerus.

SID:

  • 100–110 cm (40–44 inches).

Collimation:

  • Include shoulder joint superiorly and elbow joint inferiorly.

OTHER PROJECTIONS

3a. Lateral — Humerus (Trauma)

Positioning:

  • Patient supine or seated.
  • Arm supported horizontally on a radiolucent surface.
  • Elbow flexed 90°, hand in lateral position if possible.

Central Ray (CR):

  • Perpendicular to IR.
  • Directed to mid-humerus.

SID:

  • 100–110 cm (40–44 inches).

Collimation:

  • Include shoulder and elbow joints.

3b. Transthoracic Lateral — Humerus (Trauma)

Positioning:

  • Patient upright or supine.
  • Affected arm in neutral position at side.
  • Opposite arm elevated or behind head.
  • Breathing technique to blur lung markings.

Central Ray (CR):

  • Perpendicular to IR.
  • Directed to mid-humerus.
  • Centered at level of surgical neck.

SID:

  • 100–110 cm (40–44 inches).

Collimation:

  • Include entire humerus, shoulder, and elbow joints.

Common Pathologies Demonstrated

  • Fractures of proximal, mid, or distal humerus.
  • Dislocations of shoulder or elbow.
  • Osteoarthritis or degenerative changes.
  • Bone lesions or tumors.
  • Soft tissue swelling or foreign bodies.