Scapula x-ray in traumatology is prescribed for suspected fractures of the scapula of various localization (fracture of the body, angles, spine, anatomical and surgical neck, etc.). Standard examination is performed in two projections (straight and lateral). For radiography, the shoulder blades in a direct projection of the patient are placed on their back. At the same time, the healthy half of the chest is raised so that the shoulder blade on the side of the study fits snugly to the surface. In order to take a side shot, the patient is placed on the examined side. If this is not possible, a lateral radiograph is performed in a standing position.
An X-ray of the patient’s shoulder blade can be sent when:
- there is a suspicion of a fracture due to a previous fall, impact, accident, and so on;
- it is necessary to evaluate the result of treatment, the collection of a comminuted fracture and the rate of bone fusion;
- there is a suspicion of the presence of malignant diseases;
- it is necessary to monitor the inflammatory processes occurring in the bone tissue and adjacent joints (arthritis, arthrosis, etc.).
The X-ray will show:
- the position of the shoulder blade relative to the adjacent shoulder bones and joints;
- features of the structure of bone tissue;
- fractures, cracks, tumors, necrotic lesions;
- interstitial slits, the size of which can be judged on the condition of cartilage, tendons.
In case of a fracture of the scapula, it is important to take an X-ray in order to attribute the damage to a certain classification. Fractures can be as follows:
- articular depression;
- blade axes;
- the neck of the scapula;
- the beak – shaped or acromial process;
- longitudinal, transverse, multi-splinter;
- perforated (may be caused by a bullet wound).
The main symptoms of a shoulder blade fracture include:
- swelling in the shoulder area;
- pain when moving your hands;
- bone crunching;
- a change in the shape of the shoulder or its normal location (shoulder drooping is observed);
- pain when taking a deep breath.
The correct definition of the fracture class is the first step towards its successful elimination. I must say that, in principle, a fracture of the scapula is a rather rare case, since this bone has high strength and in order to break it, you need to apply a lot of force. Therefore, treatment can be difficult and lengthy. Even after healing and successful fusion of the bone, the patient may still feel pain when moving his hands for some time.
Sometimes, to obtain a comprehensive X-ray photo, the scapula can be taken by capturing the rib area. This may be necessary to assess multiple fractures, when it is necessary to consider where the bones have shifted, where the fragments are located, and so on.
Non-invasive X-ray does not require special training. The patient comes to the procedure, takes off his metal jewelry, glasses and undresses to the waist. If previously an operation was performed on the shoulder blade and, for example, fixing medical bolts remained in the bone, it is necessary to tell the radiologist about this. Those parts of the body that are not subject to examination are covered with special protective aprons made of lead plates.
Methodology of conducting
For scapula x-ray, various patient layouts can be used, which allows you to take pictures of the bone in several projections. To obtain a direct projection, the patient is placed on his back. The healthy side of the trunk is slightly raised, this is necessary in order to press the examined shoulder blade tightly to the table. During the shooting, the patient must remain absolutely motionless. To get a picture of the shoulder blade in a lateral projection, the patient is placed on the examined side and fixed in this position with the help of special rollers. If the pose required for the picture causes intolerable pain, the shooting can be carried out standing up.
There are a number of standard contraindications for scapula x-ray (these criteria are applicable to any X-ray examination):
- pregnancy or breast-feeding;
- children’s age (up to 15 years);
- the general serious condition of the patient.
To decipher X-ray images, a specialist evaluates certain bone parameters and compares them with standard values. Thus, the size of the scapula is estimated, its location and structure are studied. It is also important to assess the integrity of the bone. The radiologist, describing the picture, may not make a specific diagnosis. Based on his description, the diagnosis will be made by the attending physician.