How far above the humeral head should the upper margin of the IR be placed for a lateral projection of the humerus?

Citation, DOI & article data

Citation:

Shetty, A., Murphy, A. Humerus (AP view). Reference article, Radiopaedia.org. (accessed on 08 Sep 2022) https://doi.org/10.53347/rID-35282

The AP view of the humerus is part of the humerus series and is usually taken in a standing position. However, it can also be obtained in a supine position.

The projection demonstrates the humerus in its natural anatomical position allowing for adequate radiographic examination of the entire humerus and its respected articulations. 

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Humerus views are often done to exclude large humeral shaft fractures or suspected symptomatic metastatic lesions 1. If an occult fracture is suspected at either the proximal or distal end, it is best to do a separate elbow or shoulder series. 

  • the patient is preferably erect
  • the patient's back is against the image receptor
  • the affected arm is abducted and centered to the upright detector, if possible, the arm is slight externally rotated to mimic the true anatomical position
  • anteroposterior projection
  • centering point
    • mid humerus shaft
  • collimation
    • superior to the skin margins above the glenohumeral joint
    • inferior to include the distal humerus including the elbow joint
    • lateral to include the skin margin 
    • medial to include skin margin 
  • orientation  
    • portrait
  • detector size
    • 35 cm x 43 cm
  • exposure
    • 60-70 kVp
    • 7-15 mAs
  • SID
    • 100 cm
  • grid
    • yes (this can vary departmentally)

The humerus is positioned AP, evidenced by the medial and lateral epicondyles seen in profile and the greater tuberosity being seen on the lateral aspect of the humerus. The shaft is abducted away from the patient's body, minimizing superimposition

It is best to show the patient how you want their arm to rest for the projection. Often, you will have to rotate the light beam diaphragm to be aligned with the long axis of the humerus.

References

How far should the head shoulders and elbow be elevated for the Inferosuperior axial projection of the shoulder?

Shoulder Girdle/Clavicle.

Where should the central ray enter for an AP projection of the shoulder joint?

Cards
Term Which classification of bone is the Scapula?
Definition Flat
Term Which joint is a ball and socket joint?
Definition Scapulohumeral
Term When performing AP projections of the shoulder, where should the central ray be directed?
Definition 1" inferior to the coracoid process
Shoulder Girdle Flashcards - Flashcard Machinewww.flashcardmachine.com › shoulder-girdle1null

How many degrees should the elbow be angled for an AP lateral oblique projection?

An AP oblique radiograph requires the elbow to be oriented 45 degrees in internal rotation. A lateral radiograph of the elbow requires the elbow to be flexed 90 degrees with the forearm and humerus laying flat on the table and the image receptor, ulnar side down on the receptor, and thumb/radial side up.

What structure is in profile on the lateral side of the proximal humerus on the AP projection of the humerus?

True AP projection is evidenced at proximal humerus by the following: Greater tubercle is seen in profile laterally. Humeral head is partially seen in profile medially, with minimal superimposition of the glenoid cavity. Distal Humerus: Lateral and medial epicondyles both are visualized in profile.