Ap Grashey Shoulder Reduction Case Study

Abstract
In our case, a 34 year old male was brought in to the imaging department with severe shoulder pain from a basketball game he had played earlier. His physician ordered a complete trauma shoulder series of radiographs to be done on his right shoulder to get an accurate diagnosis of exactly what was causing the pain and how to effectively treat it. After the radiologist read the images, it was determined that he had suffered an anterior/inferior dislocation of his shoulder. In order to reset his shoulder, his physicians used a technique called the traction-countertraction method, which is a type of shoulder reduction. Shoulder reduction is the process of resetting the shoulder after a dislocation has occurred. After his shoulder
The views requested included an AP neutral shoulder, an AP Grashey shoulder, and an axillary projection of the shoulder (Frank, Long, & Smith, 2012). With the AP neutral view the patients arm falls as naturally as possible with the palm of the hand at the hip. In this position the humeral epicondyles should be at a 45° angle with the image receptor. The central ray should enter 1 inch below the coracoid process and a 10x12 transverse cassette should be used at 40” SID. The AP Grashey requires the patient to be obliqued 35-45° towards the affected side. For this reason, this view is often done upright. The patient’s humeral head should be in contact with the image receptor and the scapula should be parallel with the image receptor. The patient’s arm should be abducted and placed across the abdomen, palm down. The central ray should enter 2” medial and 2” inferior to the superolateral border of the shoulder. Again, a 10x12 transverse cassette should be used at 40” SID. For the axial view, an inferosuperior projection was done using the Lawrence method. This method requires the arm being extended away from the body at a right angle to the long axis of the body as close to 90° as possible. The patient’s head should be turned away from the affected side and the image receptor should be placed, on edge, against the shoulder and adjacent to the neck. The central ray should enter through the axilla to the region of the acromioclavicular joint (Frank et al., 2012). Once again, a 10x12 transverse cassette should be used at 40” SID. Since the patient was ambulatory, his exam was done upright, except the axillary view of the shoulder which was performed in the supine position. The first view performed was the AP neutral and it was apparent he had suffered a dislocation at the glenohumeral joint. Despite being in a great deal of pain, he was able to maneuver into the positions required for the additional views. After