AP CLAVICLE
Anteroposterior clavicle projection protocol
Exposure Factors
Medium exposure: Parameters for optimal visualization of clavicle and joints
Anatomical Structures Visible
Should be clearly observed:
- Complete clavicle
- Acromioclavicular joint
- Sternoclavicular joint
- Distal part of humerus
- Shoulder and adjacent region
Cassette Size and Orientation
Transverse orientation to cover complete clavicle and adjacent joints
Patient Positioning
Central Ray Point
Direction: Horizontal and perpendicular to central zone of clavicle
Location: Centered on cassette, over midpoint of clavicle
Specific Arm Position
Abduction
Arms abducted to both sides of body
Complete extension of arms
Maintain body symmetry
Head Position
Turn head towards opposite side
Avoids superposition of structures
Improves clavicular visualization
Patient Instructions
"Hold your breath during the exposure"
Maintain position without moving and in apnea during radiographic exposure
Optimal Image Characteristics
Complete clavicle
From sternum to acromion
Visible joints
Acromioclavicular and sternoclavicular
No superposition
Differentiated bone structures
Complete field
Complete clavicle and part of humerus
Common Technical Challenges
Frequent problems in AP clavicle projection:
- Rib superposition due to poor arm position
- Incorrect head rotation superposing cervical structures
- Shoulders not leveled causing image asymmetry
- Exclusion of joints due to poor cassette placement
Solution: Verify shoulder leveling and correct head rotation to opposite side
Technical Variations
Patients with Pain
Position with maximum comfort possible, adjust abduction according to tolerance.
Geriatric Patients
Consider mobility limitations in shoulder abduction.
Pediatric Patients
Reduce exposure according to age and ALARA protocol, adjust cassette size.