What proximal structure on the humerus is seen in profile medially on a true lateral of the humerus?

Citation, DOI & article data

Citation:

Hacking, C., Fahrenhorst-Jones, T. Humerus (lateral view). Reference article, Radiopaedia.org. (accessed on 08 Sep 2022) https://doi.org/10.53347/rID-39533

The lateral view of the humerus is part of the humerus series and is usually taken in a standing position. However, it can also be taken in the supine position in the acute, trauma setting.

The projection demonstrates the humerus in the lateral 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.

  • patient is preferably erect
  • patient stands facing the detector with the injured side closest to the detector 
  • patient is then rotated so that the lateral 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 or stomach to maintain position 
  • posteroanterior 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 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 positioned 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 tilt the LBD to be aligned with the long axis of the humerus.

Patients in an enormous amount of pain may struggle to bend their arm nor abduct to the ideal angle. To overcome this, let them rest their hand on their stomach instead and slowly position themselves.

There will be times where optimal positioning may not be possible. In these cases, attempt to pivot the patient less, ensuring the primary beam is directed at the mid humeral shaft and collimate very tightly to the area of interest. This will result in a suboptimal lateral projection, yet may still demonstrate the relevant pathology.

References

What is at the proximal end of the humerus medially?

The most proximal portion of the humerus is the head of the humerus, which forms a ball and socket joint with the glenoid cavity on the scapula. [1] Just inferior to the head of the humerus is the anatomical neck of the humerus, which divides the head of the humerus from the greater and lesser tubercles.

What structure is proximal and lateral on the humerus?

The greater tubercle is the most lateral portion of the proximal end of the humerus. It consists of three smooth and flat impressions at the posterosuperior aspect for the attachment of muscles.

What is proximal medial structure of the humerus?

The proximal humerus consists of the humeral head, anatomical neck, greater tuberosity, lesser tuberosity, surgical neck, and proximal shaft. Fractures of the proximal humerus (Box 4-8) are associated with osteoporosis. The majority of fractures are the result of indirect forces such as a fall onto an outstretched arm.

What structure is found on the lateral aspect of the proximal end of the humerus?

The greater tuberosity it is located lateral to the head at the proximal end. The lesser tuberosity is located inferior to the head, on the anterior part of the humerus, Its very prominent and palpable.