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Type:
Educational Exhibit
Keywords:
Trauma, Diagnostic procedure, CT, Conventional radiography, Musculoskeletal joint, Education and training
Authors:
E. Federici, C. Dell'atti, V. Martinelli, M. Bartocci, D. Beomonte Zobel, N. Magarelli, L. Bonomo; Rome/IT
DOI:
10.1594/ecr2016/C-1653
Background
The shoulder consists of three bones (clavicle,
scapula,
and proximal humerus) and four articulations (glenohumeral,
acromioclavicular,
sternoclavicular and scapulo-thoracic) (Fig.1).
Traumatic shoulder injuries include fractures of the proximal humerus,
dislocations and fracture-dislocations of the glenohumeral joint,
and fractures involving the glenoid fossa and scapular neck.
Radiologic evaluation of acute shoulder trauma is commonly performed by the emergency radiologist.
Fig. 1: Normal radiographic anatomy of the proximal humerus and lateral scapula
References: Institute of Radiology, Catholic University - Rome/IT
IMAGING
Radiographic views.
The recommended views are the trauma series of radiographs,
that is,
true anteroposterior radiographs in internal and external rotation and an axillary lateral view or a scapulolateral view.
Additional views may include modifications to the AP view (the neutral position),
an axial view (superoinferior or inferosuperior) or transthoracic lateral view (Fig.2).
Fig. 2: Anteroposterior radiographs in internal (a) and external (b) rotation. Axillary lateral view (c) and transthoracic lateral view (d).
References: Institute of Radiology, Catholic University - Rome/IT
Computer tomography
CT scan reliably demonstrates fractures,
the number of fracture fragments,
and fracture-dislocations of gleno-humeral joint.
Three-dimensional CT scan can provide additional information in the acute setting to evaluete complex and multiple shoulder girdle fractures (Fig.3).
Fig. 3: 3D computed tomography (CT) image of the shoulder.
References: Institute of Radiology, Catholic University - Rome/IT