醫(yī)學(xué)影像技術(shù)：3上肢骨的X線攝影

上肢骨的X線攝影

Radiographicpositionsofarms

四肢骨的影像學(xué)四肢由骨骼、骨間關(guān)節(jié)、肌肉、肌腱、血管、皮膚和軟組織組成ImagingoftheextremitiesTheextremitiesconsistedofjoints、muscles、tendons、vessels、skinsandsofttissues.平片檢查常用于骨外傷、骨發(fā)育、病理性骨改變、多種骨和關(guān)節(jié)病的檢查等等。骨外傷骨發(fā)育病理性骨改變多種骨和關(guān)節(jié)病Radiographicexaminationisusedtoexaminebonetrauma、skeletalmaturity、pathologicalchanges、variousdiseaseoftheboneandjointandsoon.bonetraumaskeletalmaturitypathologicalchangesboneandjointdiseases平片還可以顯示軟組織內(nèi)的鈣化、金屬異物的位置。金屬異物的位置軟組織內(nèi)的鈣化Radiographicexaminationcanalsoshowthepositionofcalcificationandmetallicforeignbodiesinsofttissue.MetallicforeignbodiesCalcification四肢骨的攝影注意事項1.平片應(yīng)包括所需骨骼及其周圍軟組織2.攝長骨至少包括鄰近一端的關(guān)節(jié)3.同一膠片攝取兩個位置時應(yīng)方向一致Notesoftheextremitiesexposure1.Itshouldincludetheboneandthesofttissueweneeded.2.LongboneX-rayimageshouldincludeaadjacentjointatleast.3.Theorientationsoftwobodiespartsshouldbeaccordantinonephoto.4.長骨的長軸應(yīng)與膠片的長軸平行5.SID為75～100cm，電壓應(yīng)病情而增減75～100cm4.The

long

axis

of

both

long

bone

and

x-ray

photo

should

be

parallel.5.TheSIDisfrom75cmto100cm，andthevoltageshouldbeincreasedordecreasedaccordingtopatient'scondition.75～100cm6.骨傷患者應(yīng)小心擺位，使用輔助用具7.一般不用濾線器，體厚處需用濾線器6.Weshouldtreatfracturepatientsverycarefully,usingauxiliaryappliancesifnecessary.7.Ingeneral,X-rayfilterdonothavetobeusedexceptthickposition.手后前位（正位）攝影

anteroposteriorprojectionofhand手后前位（正位）攝片目的：觀察手骨的形態(tài)、關(guān)節(jié)、異物、骨齡anteroposteriorprojectionofhandPurpose：

Toobservetheshapeofhandbones、joint、foreignbodies

andboneage.攝影體位：病人側(cè)坐于攝影臺前，被檢側(cè)手平放在暗盒上，各指展開，掌心向下，第3掌骨置于照片中心。雙手時應(yīng)雙手對稱地放在暗盒上中心線：單手：第3掌骨頭雙手：照片中心Posture：Patientsitsidewaysinfrontoftheplanigraphycouchandputthehandbeingexaminedonthecassettewithfingersspreading、palmsdown，andthefirstmetacarpusisplacedinthecenterofphoto.Ifbothbandsareaskedtoberadiographed，putthemonthecassettesymmetrically.Centreline：Singlehand：thethirdmetacarpusBothhands：thecenterofphoto.手后前位橈骨尺骨橈掌關(guān)節(jié)掌腕關(guān)節(jié)遠節(jié)指骨中節(jié)指骨近節(jié)指骨指間關(guān)節(jié)掌指關(guān)節(jié)拇指腕豆骨第5掌骨第1掌骨RadiusUlnaWristjointsCarpometacarpaljointDistalphalanxMiddlephalanxProximalphalanxInterphalangealjointMetacarpophalangealjointsThumbPisiformThefifthmetacarpusThefirstmetacarpusSesamoid標(biāo)準(zhǔn)片：1.照片包括掌骨、指骨及腕關(guān)節(jié)2.各指骨間隔狀分開3.拇指呈斜位影像4.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Includemetacarpi、phalanges

andwristjoints.2.Eachphalanx

spreadevenly3.Thumb

isoblique4.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.RLR手指未展開

Fingersdoesnotopen異物

foreignbodiesR手指未展開Fingersdoesnotopen不美觀unsightly標(biāo)記不正確Themarkisnotcorrect盡可能避免其他異物的影像(如大人的手)Avoidotherforeignbodiessuchasadulthandsasfaraspossible手側(cè)位

lateralprojectionofhand手側(cè)位

lateralprojectionofhand攝片目的：觀察手部軟組織內(nèi)異物的位置Purpose：

Toobservethepositionofforeignbodiesinthesofttissue.攝影體位：病人側(cè)坐于攝影臺前，腕部及手指伸直，拇指位于其余四指前方，第5掌骨緊貼平板，手掌與平板垂直，第5掌骨于照片中心中心線：第2掌骨頭Posture：

Patientsitsidewaysinfrontoftheplanigraphycouchandkeephiswristandfingersstraightwiththumblocatedinthefrontofother4fingers.Thepalmshouldbeverticaltotheflatplateandthefifthmetacarpusclosestotheflatplate.Thefifthmetacarpusisplacedinthecenterofphoto.Centreline：thesecondmetacarpus指骨掌骨腕關(guān)節(jié)尺骨橈骨第1掌骨近節(jié)指骨遠節(jié)指骨PhalanxMetacarpusWristjointsUlnaRadiusFirstmetacarpusProximalphalanxDistalphalanxJapanesemethodChinesemethodOverlappedmetacarpalsRingfingerthumb標(biāo)準(zhǔn)片：1.第2-5掌骨指骨相互重疊，2.重疊的掌骨與照片長軸重合3.拇指呈正位4.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Metacarpi2through5shouldoverlapswitheachother.2.ThelongaxisofbothoverlappingmetacarpiandX-rayphotoshouldbeparallel.3.Thumbisposteroanterior.4.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.RL恬靜蘇黎世的清晨歐洲之巔手后前斜位

Pronationobliqueprojectionofhand手后前斜位

pronationobliqueprojectionofhand攝影目的：觀察手部骨外傷和骨質(zhì)的病變，主要是第2、3掌指骨關(guān)節(jié)影像Purpose：

Toobservebonetraumaandpathologicalchangesofhand，especiallythesecondandthirdmetacarpi.攝影體位：手掌向內(nèi)傾斜，第5掌骨緊貼平板，使手掌與平板成45°角，各指均勻分開稍彎曲，第3掌骨頭置于平板中心中心線：第3掌骨頭Posture：

Thepalmtiltinwardata45degreeangle,andthefifthmetacarpusclosestotheflatplatewithfingersslightlycurvedandspreading.Thethirdmetacarpusisplacedinthecenterofphoto.Centreline：thethirdmetacarpus手后前斜位月骨三角骨舟骨大多角骨小多角骨遠節(jié)指骨中節(jié)指骨近節(jié)指骨尺骨橈骨腕豆骨鉤骨頭狀骨第5掌骨第1掌骨LunateTriangularboneScaphoidTrapeziumTrapezoidDistalphalanxMiddlephalanxProximalphalanxUlnaRadiusPisiformHamateCapitateThefifthmetacarpusThefirstmetacarpus標(biāo)準(zhǔn)片：1.掌骨及腕關(guān)節(jié)呈斜位影像2.第3掌指關(guān)節(jié)在照片的正中3.拇指呈側(cè)位影像4.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.

Metacarpiandwristjointareoblique.2.Thethirdmetacarpophalangealjointisplacedinthecenterofphoto.3.Thumbislateral.4.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.RLRL體位不佳

Poorposture體位不佳

Poorposture腕關(guān)節(jié)正位

Posteroanteriorprojectionofwristjoint腕關(guān)節(jié)正位攝影目的：觀察腕骨、掌骨近端、尺橈骨遠端的骨質(zhì)、關(guān)節(jié)及周圍軟組織的情況。觀察小兒發(fā)育，了解骨齡腕關(guān)節(jié)正位

PosteroanteriorprojectionofwristjointPurpose：Toobversesclerotinofcarpus、distalradiusandulnaandproximalmetacarpalsaswellasperiarticularsofttissues.Toobverseboneageinordertounderstandthegrowthofchildren.攝影體位：被檢側(cè)前臂彎曲，手呈半握拳狀，掌面向下，腕關(guān)節(jié)置于平板中心中心線：尺骨、橈骨莖突連線中點Posture：Theexaminedforearmcurve，andkeephandinaunclenchedfistwithpalmdown.Wristjointisplacedinthecenteroftheflatplate.Centreline：themidpointbetweenradialmalleolusandstyloidprocessofulna.腕關(guān)節(jié)正位鉤骨腕豆骨月骨三角骨舟骨頭狀骨小多角骨大多角骨尺骨橈骨第1掌骨第5掌骨HamatePisiformLunateTriquetralScaphoidCapitateTrapezoidTrapeziumUlnaRadiusThefirstmetacarpusThefifthmetacarpusHapezoidHapiziumScaphoidLunateCapitateHamatePisiformTriquetral標(biāo)準(zhǔn)片：1.腕關(guān)節(jié)各骨位于照片正中2.手呈半握拳狀影像3.第3掌骨、尺橈骨與照片長軸平行4.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Allboneofwristjointisplacedinthecenterofphoto.2.keepthehandinaunclenchedfist.3.Thelongaxisofthethirdmetacarpus、radius、ulnaandX-rayphotoshouldbeparallel.4.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.RLR雙手正位Posteroanteriorprojectionofhand腕關(guān)節(jié)側(cè)位

lateralprojectionofwristjoint腕關(guān)節(jié)側(cè)位

lateralprojectionofwristjoint攝影目的：觀察腕骨、尺橈骨下端、腕橈關(guān)節(jié)的外傷、月骨的脫位Purpose:Toobversetraumaofcarpus、distalradiusandulna.Toobverselunatedislocation.攝影體位：被檢側(cè)前臂彎曲，第五掌骨和前臂尺側(cè)緊靠平板中心線：橈骨莖突Posture：

Theexaminedforearmcurve.Thefifthmetacarpusandulnarforearmshouldbeclosedtotheflatplate.Centreline：Radialmalleolus腕關(guān)節(jié)側(cè)位尺骨橈骨大多角骨小多角骨舟骨鉤骨頭狀骨腕豆骨第1掌骨月骨UlnaRadiusTrapeziumTrapezoidScaphoidHamateCapitatePisiformThefirstmetacarpusLunate標(biāo)準(zhǔn)片：1.腕關(guān)節(jié)呈側(cè)位顯示2.尺橈骨遠端重疊良好，并與照片長軸重疊3.月骨位于照片正中4.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Wristjointislateral2.Distalradiusandulnaareoverlapping,andthelongaxisbothofitandX-rayphotoshouldbeparallel.3.

Lunateisplacedinthecenterofphoto.4.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.RLRL阿爾卑斯山的小鎮(zhèn)迷人的少女峰冰川列車縱覽歐洲腕關(guān)節(jié)蝶氏位

（尺偏位）

Ulnardeviationprojectionofwristjoint腕關(guān)節(jié)蝶氏位（尺偏位）

ulnardeviationprojectionofwristjoint攝影目的：觀察舟骨的病變和外傷情況Purpose：Toobversethetrauma

andpathologicalchangesofscaphoid.攝影體位：被檢側(cè)前臂伸直，掌面向下并盡量外展偏向尺側(cè)，腕關(guān)節(jié)置于平板中心中心線：尺骨、橈骨莖突的連線中點Posture：Keeptheexaminedforearmstraightandpalmdownandoutwardasmuchaspossible.Wristjointisplacedintheflatplate.Centreline：themidpointbetweenradialmalleolusandstyloidprocessofulna.第1掌骨舟骨橈骨尺骨第5掌骨大多角骨小多角骨頭狀骨月骨腕豆骨三角骨鉤骨ThumbScaphoidRadiusUlnaFifthmetacarpalHapiziumCapitateLunatePisiformTriquetralHamateHapezoidR標(biāo)準(zhǔn)片：1.腕關(guān)節(jié)各骨位于照片正中2.舟骨與其他小骨分離良好3.尺橈骨與照片長軸平行4.左右（L、R）標(biāo)記在影像左上角Standardimage：1.

Each

bone

of

the

wrist

in

median

photos

2.

Navicular

bone

separated

well

with

other

small

bones

3.Radius

and

ulna

parallel

to

the

long

axis

of

photos

4.

Left

orright

(L,

R)

is

stampedin

the

upper

left

corner

LR尺橈骨前后位

（正位）

Anteroposteriorprojectionofradiusandulna尺橈骨前后位（正位）

Anteroposteriorprojectionofradiusandulna攝影目的：觀察尺橈骨的骨質(zhì)、軟組織及異物情況Purpose：Toobversethesclerotinofradiusandulna、softtissueandforeignbodies.攝影體位：被檢側(cè)前臂伸直，掌面向上，背面緊靠平板，上緣包括肘關(guān)節(jié)，下緣包括腕關(guān)節(jié)中心線：前臂中點Posture：Keeptheexaminedforearmstraightandpalmup.Thebackofhandshouldclosetotheflatplate.Includeelbowandwristjoint.Centreline：themidpointofforearm尺橈骨正位尺骨遠端橈骨遠端尺骨鷹嘴橈骨尺骨OlecranonprocessRadiusUlnaRadialtuberosityHeadofradiusUlnarstyloidprocessRadialstyloidprocess標(biāo)準(zhǔn)片：1.尺橈骨與照片長軸平行2.腕關(guān)節(jié)在照片的上端，肘關(guān)節(jié)在下端3.尺橈骨近端少量重疊，遠端分離良好4.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.

ThelongaxisofbothradiusandulnaandX-rayphotoshouldbeparallel.2.WristjointisatthetopofX-rayphoto,whileelbowjointatthebottomoftheimage.3.Theproximalradiusandulnaareslightlyoverlapping，andthedistalradiusandulnaareseparated.4.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.RLR尺橈骨側(cè)位

Lateralprojectionofradiusandulna尺橈骨側(cè)位

Lateralprojectionofradiusandulna攝影目的：觀察尺、橈骨的骨質(zhì)、軟組織及異物情況Purpose：Toobversethesclerotinofradiusandulna、softtissueandforeignbodies.攝影體位：被檢側(cè)肘部彎曲成直角，尺側(cè)在下，上緣包括肘關(guān)節(jié)，下緣包括腕關(guān)節(jié),拇指朝上中心線：前臂中點Posture：Keeptheexaminedelbowbentatrightanglesandtheulnarsideshouldclosetotheflatplatewiththumbup.Includeelbowandwristjoint.Centreline：themidpointofforearm.尺骨鷹嘴肱骨尺骨橈骨橈骨莖突尺骨莖突RadialstyloidprocessUlnarstyloidprocessOlecranonprocessShaftofhumerusRadiusUlnaCoronoidprocessRadialneckR標(biāo)準(zhǔn)片：1.尺橈骨與照片長軸平行2.腕關(guān)節(jié)在照片的上端，肘關(guān)節(jié)在下端3.尺橈骨重疊良好4.尺橈骨與肱骨夾角90°5.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.helongaxisofbothradiusandulnaandX-rayphotoshouldbeparallel.2.WristjointisatthetopofX-rayphoto,whileelbowjointatthebottomoftheimage.3.Radiusandulnaareoverlappingwell4.Radius、ulnaandhumerusformanangleof90degree.5.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.L上下顛倒Upsidedown影像不美觀

unsightly標(biāo)記不佳

themark

isn’tcorrect.影像模糊Vagueimage肘關(guān)節(jié)前后位

（正位）

anteroposteriorprojectionofwristjoint肘關(guān)節(jié)前后位（正位）

anteroposteriorprojectionofwristjoint攝影目的：觀察肘關(guān)節(jié)的骨質(zhì)、軟組織及脫位情況Purpose：Toobservesclerotinofelbow、softtissueandluxation.攝影體位：被檢側(cè)前臂伸直，掌面向上，肩部放低，肘部緊靠平板中心線：肱骨內(nèi)外上髁連線中點Posture：Keeptheexaminedforearmstraightandpalmup,andmaketheelbowclosetotheflatplate.Centreline：themidpointoflateralepicondyleandmedialepicondyleofhumerus.肘關(guān)節(jié)正位尺骨鷹嘴肱骨尺骨橈骨外上髁內(nèi)上髁橈骨小頭ShaftofhumerusLateralepicondyleHeadofradiusOlecranonfossaOlecranonprocessMedialepicondyleSuperiorradioulnarjointRadialtuberosity標(biāo)準(zhǔn)片：1.尺橈骨、肱骨與照片長軸平行2.肱骨在照片的上端，尺橈骨在下端3.尺橈骨少量重疊，內(nèi)上髁顯示清晰4.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Thelongaxisofradius、ulna、humerusandX-rayphotoshouldbeparallel.2.HumerusisatthetopofX-rayphoto,whileradiusandulnaatthebottomoftheimage.3.Radiusandulnaareslightlyoverlapping.Medialepicondyleisclear.4.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.RL肘關(guān)節(jié)側(cè)位

Lateralprojectionofelbowjoint肘關(guān)節(jié)側(cè)位

Lateralprojectionofelbowjoint攝影目的：觀察肘關(guān)節(jié)的骨質(zhì)、軟組織和脫位的情況Purpose：Toobservesclerotinofelbow、softtissueandluxation.攝影體位：被檢側(cè)肘部彎曲成直角，橈側(cè)在上，肩部放低使肘部緊貼平板,拇指向上中心線：肱骨外上髁Posture：Keeptheexaminedelbowbentatrightanglesandtheulnarsideshouldclosetotheflatplatewiththumbup.Centreline：lateralepicondyleofhumerus.肘關(guān)節(jié)側(cè)位尺骨橈骨肱骨尺骨鷹嘴肱骨小頭橈骨小頭肘關(guān)節(jié)ShaftofhumerusOverlappedmedialandlateralepicondylesOlecranonprocessCoronoidprocessHeadofradius90o標(biāo)準(zhǔn)片：1.肱骨與尺橈骨夾角為90°2.肱骨在照片的上端，與照片長軸平行3.尺骨與肱骨的關(guān)節(jié)間隙清晰4.肱骨內(nèi)外髁重疊呈圓形5.左右（L、R）標(biāo)記在影像左上角R尺骨Standardimage：1.Radius、ulnaandhumerusformanangleof90degree.2.Humerusisatthetopandparalleltolongaxisofphoto.3.Elbowjointspaceisclear.4.Overlappedmedialandlateralepicondylesareoverlappingandshouldbeacircular.5.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.R尺骨LL左肘關(guān)節(jié)正側(cè)位AnteroposteriorandlateralprojectionofleftelbowjointR右肘關(guān)節(jié)正側(cè)位AnteroposteriorandlateralprojectionofrightelbowjointR肱骨不平行Humerusisn’tparallelwiththephoto彎曲不佳Insufficientbending標(biāo)記不正確Themarkisn’tcorrect.童話世界圣誕老人的故鄉(xiāng)肱骨前后位（正位）

Anteroposteriorprojectionofhumerus肱骨前后位（正位）

Anteroposteriorprojectionofhumerus攝影目的：觀察肱骨的骨質(zhì)、軟組織和異物情況Purpose：Toobversesclerotinofhumerus、softtissueandforeignbody.攝影體位：病人仰臥于攝影臺上，手臂伸直，外展，掌面向上，上緣包括肩關(guān)節(jié)，下緣包括肘關(guān)節(jié)中心線：肱骨中點Posture：Thepatientliesonhisbackandkeeptheexaminedarmstraightandabducingwithpalmup.Includeshoulderandelbowjoint.Centreline：themidpointofhumerus肱骨頭肱骨內(nèi)上髁外上髁鷹嘴窩LAnatomicalneckShaftofhumerusSurgicalneckLessertuberosityHeadofhumerusR標(biāo)準(zhǔn)片：1.肩關(guān)節(jié)在照片的上端，肱骨與照片長軸平行2.大結(jié)節(jié)呈切線位，小結(jié)節(jié)與肱骨重疊

3.肱骨頭與關(guān)節(jié)盂有少量重疊4.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Shoulderjointisatthetopofphoto，andthehumerusisparalleltothelongaxisofphoto.2.Greatertuberosityistangent，andlessertuberosityoverlapshumerus.3.Headofhumerusoverlapsglenoidcavityslightly.4.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.L肱骨側(cè)位

Lateralprojectionofhumerus肱骨側(cè)位

Lateralprojectionofhumerus攝影目的：觀察肱骨的骨質(zhì)、軟組織和異物情況Purpose：Toobversesclerotinofhumerus、softtissueandforeignbody.攝影體位：病人仰臥于攝影臺上，肘關(guān)節(jié)彎曲內(nèi)轉(zhuǎn)成側(cè)位，上緣包括肩關(guān)節(jié)，下緣包括肘關(guān)節(jié)中心線：肱骨中點Posture:

the

patient

supine

on

the

photographic

table,

the

elbow

bent

inside

into

lateral,

the

upper

edge

including

the

shoulder

joint,the

lower

edge

including

the

elbow.

Center

line:

the

midpoint

of

the

humerus.

肱骨頭肱骨干橈骨尺骨肘關(guān)節(jié)RROlecranonprocessRadiusUlnaShaftofhumerusHeadofhumerusR標(biāo)準(zhǔn)片：1.肩關(guān)節(jié)在照片的上端，肱骨與照片長軸平行2.大結(jié)節(jié)與小結(jié)節(jié)完全重疊

3.肱骨頭與關(guān)節(jié)盂有部分重疊4.肘關(guān)節(jié)呈側(cè)位顯示5.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Shoulderjointisatthetopofphoto，andthehumerusisparalleltothelongaxisofphoto.2.Greatertuberosity

andlessertuberosityareoverlappingcompletely.3.Headofhumerusoverlapsglenoidcavitypartly.4.Elbowjointislateral.5.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.L肩關(guān)節(jié)前后位

（正位）

Anteroposteriorprojectionofshoulderjoint肩關(guān)節(jié)前后位（正位）

Anteroposteriorprojectionofshoulderjoint攝影目的：觀察肩關(guān)節(jié)、肩鎖關(guān)節(jié)的骨折和脫位的情況Purpose：Toobservefractureofshoulderjoint

andacromioclavicularjointaswellasluxation.攝影體位：病人站立于攝影架前，上肢伸直并外展，掌心向前，對側(cè)向前斜（15°），肩部緊貼平板中心線：喙突Posture：

Thepatientstandsinfrontoftheradiographystand，andtheexaminedarmstraightandabducingwithpalmforward.Theoppositesideison15-degreetiltedtomaketheexaminedshoulderclosetotheflatplate.Centreline：coracoid肩關(guān)節(jié)正位肩峰肱骨頭肩關(guān)節(jié)肱骨肩胛骨鎖骨ClavicleScapulaRibsGlenoidfossaAcromioclavicularjointAcromionprocessDepressionSurgicalneckoffemurGreatertuberosityLessertuberosity標(biāo)準(zhǔn)片：1.肩關(guān)節(jié)顯示于照片正中2.肩關(guān)節(jié)盂前后緣重疊呈切線，關(guān)節(jié)間隙清晰3.肱骨與照片長軸平行4.左右（L、R）標(biāo)記在影像左上角RStandard：1.Shoulderjointisplacedinthecenterofphoto.2.Theanteriorandposteriorbordersofglenoidcavityareoverlappingandtangent.Thejointspaceisclear.3.Humerusisparalleltothelongaxisofphoto.4.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.RLR關(guān)節(jié)盂前后緣與肱骨頭影像重疊Theanteriorandposteriorbordersofglenoidcavityoverlapstheheadofhumerus.關(guān)節(jié)盂出現(xiàn)雙邊影Theglenoidcavityhasdoubleedgeshadow標(biāo)準(zhǔn)體位Standardposture肩關(guān)節(jié)側(cè)位（穿胸位）

Lateralprojectionofshoulderjoint

（throughthechest）肩關(guān)節(jié)側(cè)位（穿胸位）

Lateralprojectionofshoulderjoint攝影目的：觀察肱骨的頭、頸、骨干的情況Purpose：Toobversethehead、neckandshaftofhumerus.攝影體位：病人側(cè)立于攝影架前，被檢側(cè)上肢自然下垂并緊貼平板，對側(cè)抱頭，盡量使對側(cè)肩部上移，深吸氣后屏氣曝光中心線：經(jīng)對側(cè)腋下水平射入Posture：

Thepatientstandssidewaysinfrontoftheradiographystand.Lettheexaminedarmfallnaturallyandclosetotheflatplate.Holdhisheadintheoppositehand

andmaketheoppositeshouldermoveup.Exposebreathlesslyafterinhalingdeeply.Centreline：

Throughtheoppositeunderarmhorizontally鎖骨肱骨頸肋骨肱骨頭AcromionprocessSurgicalneckoffemurRibsHeadofhumerus標(biāo)準(zhǔn)片：1.肱骨頭位于脊柱與胸骨之間2.肱骨不與胸椎重疊3.肺部含氣量充分，肱骨上段與周圍組織界限分明4.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Headofhumerusisbetweenthespineandbreastbone.2.Humerusdoesnotoverlapsthethoracicvertebra3.Thegascontentoflungisabundant.Proximalhumerushasaclearlimitoutofthesurroundingtissue.4.

Leftorright（L、R）isalwaysmarkedintheupperleftcorner.RL肩胛骨正位

Anteroposteriorprojectionofshoulderblade

肩胛骨正位

Anteroposteriorprojectionofshoulderblade攝影目的：觀察肩胛骨的形態(tài)和結(jié)構(gòu)Purpose：Toobversetheshapeandstructureofshoulderblade.攝影體位：病人站立于攝影架，被檢側(cè)上肢外展與軀干垂直，肘部彎曲90°角，背部緊貼平板中心線：喙突下方5cmPosture：

Thepatientstandsinfrontoftheradiographystand，keeptheexaminedarmabducing

andperpendiculartothetrunk.Lettheexaminedelbowbentatrightangles.Thebackisclosedtotheflatplate.Centreline：theplaceabout5cmbelowthecoronoidprocess.肩胛骨正位喙突關(guān)節(jié)盂肩峰鎖骨肩胛骨下角肩胛骨上角肩胛骨外緣肩胛骨內(nèi)緣肱骨頭CoracoidprocessClavicleScapulaGlenoidfossaR標(biāo)準(zhǔn)片：1.肩胛骨呈三角形顯示于照片正中，邊緣銳利2.肩胛骨內(nèi)緣與肋骨少量重疊

3.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Shoulderbladeistriangularwithsharpedgeandplacedinthecenterofphoto.2.Inneredgeofshoulderbladeoverlapsribsslightly.

3.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.L肩胛骨正位改良位LImprovedanteroposteriorprojectionofshoulderblade肩胛骨側(cè)位

Lateralprojectionofshoulderblade肩胛骨側(cè)位

Lateralprojectionofshoulderblade攝影目的：觀察肩胛骨側(cè)位影像和結(jié)構(gòu)Purpose：Toobversethelateralshapeandstructureofshoulderblade.攝影體位：病人站立于攝影架前，被檢側(cè)胸壁緊貼平板，手抱頭，肩胛骨內(nèi)外緣垂直平板中心線：肩胛骨內(nèi)緣中點，平靜呼吸下屏氣曝光Posture：

Thepatientstandssidewaysinfrontoftheradiographystand.Keeptheexaminedlateralthoracicclosetotheflatplateandholdtheheadinhishand.

Innerandouteredgeofshoulderbladeareperpendicularto

theflatplate.Centreline：themidpointofinneredgeofshoulderblade，exposebreathlesslyafternormalrespiration.肩胛骨側(cè)位肱骨肩峰鎖骨關(guān)節(jié)盂肩胛骨下角肩胛骨腋緣肩胛骨背側(cè)緣肩胛骨脊柱緣喙突肱骨頭AcromionprocessGlenoidfossaHeadoffemurLateralborderofscapulaClavicleR標(biāo)準(zhǔn)片：1.肩胛骨投影于肋骨外側(cè)

2.肩胛骨呈“Y”字形顯示于照片正中，邊緣銳利3.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Shoulderbladeisoutsideofribs.2.Shoulderbladeis“Y”typewithsharpedgeandplacedinthecenterofphoto.

3.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.L鎖骨后前位

（正位）

Posteroanteriorprojectionofclavicle鎖骨后前位（正位）

Posteroanteriorprojectionofclavicle攝影目的：觀察鎖骨的正位影像Purpose：Toobversetheshapeofclavicle攝影體位：病人俯臥于攝影臺，被檢側(cè)鎖骨緊貼平板中心線：鎖骨中點，平靜呼吸下屏氣曝光Posture：Thepatientliesproneintheflatplate，andtheexaminedclavicleisclosedtotheflatplate.

Centreline：themidpointofclavicle，exposebreathlesslyafternormalrespiration.鎖骨正位鎖骨胸骨端第1肋骨第2肋骨鎖骨肩峰端鎖骨肱骨頭ClavicleCoracoidprocessAcromioclavicularjointAcromionprocess標(biāo)準(zhǔn)片：1.鎖骨內(nèi)1/3與胸廓重疊2.鎖骨呈S形顯示于照片正中，邊緣銳利3.左右（L、R）標(biāo)記在影像左上角RStandardimage：1.Inner1/3clavicleoverlapsthorax.2.Clavicleis“S”typewithsharpedgeandplacedinthecenterofphoto.3.Leftorright（L、R）isalwaysmarkedintheupperleftcorner.RL總結(jié)四肢骨的影像學(xué)組成？常規(guī)檢查？平片顯示？SUMMARYImagingoftheextremities

components？

normalexamination？

plainfilm？四肢骨的攝影注意事項1.平片應(yīng)包括所需骨骼及其周圍軟組織2.攝長骨至少包括鄰近一端的關(guān)節(jié)3.同一膠片攝取兩個位置時應(yīng)方向一致4.長骨的長軸應(yīng)與膠片的長軸平行5.焦片距為75～100cm，