Shoulder Image Critque

            For the first projection of the AP shoulder, external rotation, a 10 x 12 inch cassette was used crosswise to obtain the image using the Wall Bucky. The source to image receptor distance was 40 inches to the Wall Bucky. A gown was provided to the patient and the patient was instructed to remove his clothing and all the jewelry or body piercings that he might have around the shoulder area. A lead shield was placed around the patient's waist to protect his reproductive organs from the radiation exposure. The patient was standing upright facing toward the x-ray tube and the patient's back was to the mid-line of the grid. The patient was instructed to spread his feet apart so that there was equal weight distributed on the feet. The patient's arms were both on the lateral side of the body. The central ray was perpendicular to the center of the image receptor and entering to one inch inferior to coracoid process. The patient's left arm was rotated externally with the hand supinated. This was done to place to humeral epicondyles parallel to the image receptor. .
             The respiration for this projection was fully inspiration to prevent any motion that might occur. The structures shown on the radiograph are the entire clavicle, the scapula, the AC and SC joints, the glenoid cavity, coracoid process, the acromion, the proximal humerus and the greater tubercle. There are no artifacts present on the image or in the area of interest. There is no pathology present on the radiograph. Both my left marker and the technologist's left marker are visible on the radiograph. The patient measured at 15 cm so a technique of 80 kVp at a 20 mAs was used. There is good recorded detail and minimum distortion on the radiograph. The image is a little under penetrated. There is high subject contrast due to few shades of gray. I would not repeat this examination, but I would adjust the technical factors by increasing the kVP by 15%.