Radiographic Views and Clues
WHAT TO LOOK FOR/TIPS • Used to assess for AC joint separation • Compare injured to non-injured side • Widening of joint • Elevation of clavicle relative to acromion • Inferior surfaces should line up (not superior)
• Axillary: clavicle should line up anteriorly with acromion; however, a small amount of posterior positioning of the clavicle is usually WNL • Some facilities perform the AP with weights strapped to the wrists to enhance offset in the setting of AC separation • Our surgeons do not torture patients with this: if AC separation is significant enough to warrant treatment, it will be apparent without the use of weights
WHAT TO LOOK FOR • Techs are supposed to use a marker to indicate the site of pain—feel free to QA the case if they do not • In your reports: do not number the fingers, name them • Avoids confusion/misnumbering
WHAT TO LOOK FOR
WHAT TO LOOK FOR • Rarely obtained • Historically for SC dissocation (dislocation) • With anterior dislocation of the medial clavicle, it will appear elevated on the serendipity view (posterior appears depressed) • CT scan is always the study of choice for SC dissociation • These days, radiographs may be 1st study requested to assess a lump • Usually fruitless and CT or MR obtained later • N.b.: most lumps at the SC joint turn out to be DJD
• Oblique views not always obtained
WHAT TO LOOK FOR • Especially on the angled view, the undersurface of the clavicle is irregular and may simulate a healed fracture even when normal • When plate and screws are present, it is often challenging to discern the presence of callus; in addition, the fracture lines are often obscured • Our main job: assess for changes in alignment and position
WHAT TO LOOK FOR • Alignment at the wrist and elbow are important; however, forearm radiographs do not represent proper positioning to assess either joint does not represent a shortcut to assessing the joints also, those must be ordered separately