Humerus (lateral view)

Dr Craig Hacking et al.

Lateral view of the humerus is part of the humerus series and is usually taken in standing position. However, it can also be taken in the 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. 

  • patient is preferably erect
  • patient stands facing the detector with the injured side closest to the detector 
  • patient is then rotated so that the anterior aspect of the shoulder of the affected side, the arm and the elbow are all in contact with the upright bucky
  • the elbow is flexed 90° (as close to 90° as possible) 
  • place the patient's hand on their ASIS to maintain position 
  • posteroanterior projection
  • centring 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 medial 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)
  • medial and lateral epicondyles superimposed and scapula in lateral (Y-shaped) position
  • humerus is placed away from the patient's body, minimising superimposition

It's best to show the patient how you want their arm to rest for the projection. Often you will have to tilt the LBD to be aligned with the long axis of the humerus. 
Humerus views are often done to exclude large mid-shaft humeral fractures or suspected symptomatic metastatic lesions 1, if an occult fracture is suspected at either the proximal or distal end, it's best to do a separate elbow or shoulder series. 

Patients in an enormous amount of pain will not be able to bend their arm nor abduct to the ideal angle, the way to overcome this is to let them rest their hand on their stomach and slowly position themselves.

There will be times where this is not possible, in these cases attempted to pivot the patient less, ensure the primary beam is centred to the midshaft and collimate very tight to the area of interest. This will result in a suboptimal lateral projection, yet may still demonstrate the relevant pathology.

 

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Article information

rID: 39533
Section: Radiography
Synonyms or Alternate Spellings:
  • Humerus: lateral view

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Cases and figures

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    Lateral humerus P...
    Figure 1: lateral humerus positioning (Right)
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    Lateral Humerus (...
    Figure 2: lateral humerus image (Left)
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    Lateral Proximal ...
    Figure 3: lateral proximal humerus positioning (left)
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    Lateral Proximal ...
    Figure 4: lateral proximal humerus image (right)
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