AP Humerus

Complete AP Humerus Radiograph

Exposure Factors

60-65

Kilovoltage (kV)

15-20

Milliamperage (mAs)

Fine Focus

Focus Type

105-115 cm

Source-Image Distance

Medium exposure: Optimized parameters for complete humerus visualization

Bucky Configuration

With Bucky

Recommended

Better image quality

Without Bucky

Alternative

In special cases or technical limitations

Anatomical Structures Visible

Should be clearly observed:

Complete humerus from shoulder joint to elbow
Shoulder joint (glenohumeral)
Elbow joint
Complete humeral diaphysis
Proximal and distal epiphysis of humerus

Joint inclusion verification:

SHOULDER JOINT

Glenohumeral included

ELBOW JOINT

Complete elbow visible

Complete evaluation: Both joints must be included for proper humerus assessment

Cassette Size and Orientation

30 × 35 cm

Longitudinal

Standard

Longitudinal orientation to cover complete humerus from shoulder to elbow

Patient Positioning

Patient in standing position

Posterior part of body in contact with bucky

Place arm in center of bucky

Arm in sufficient abduction to avoid superposition with other body parts

Arm completely extended

Hand in supine position (palm upward)

Center humerus on cassette

Central Ray Point

Center of arm

Direction: Horizontal and perpendicular to center of arm

Centering: At center of cassette

Objective: Midpoint of humerus between shoulder and elbow

Specific Arm Position

Abduction

Arm separated from body

Sufficient to avoid thoracic superposition

Generally 15-30° from body

Hand Position

Complete supination

Palm upward

Elbow extended

Patient Instructions

"Do not breathe during the exposure"

Maintain position without movement and apnea during radiographic exposure

1. "Stand straight with your back against the bucky"
2. "Keep your arm away from your body"
3. "Turn your palm upward"
4. "Take a deep breath and hold it"
5. "Do not move during the exposure"

Optimal Image Characteristics

Complete humerus

From shoulder to elbow

No Superposition

Separated from thoracic structures

Joints visible

Shoulder and elbow included

Full field

Complete humerus in its length

Common Technical Challenges

Frequent problems in AP humerus projection:

Insufficient abduction causing humerus superposition with thorax
Incomplete supination affecting humeral rotation
Exclusion of joints from poor cassette placement
Arm rotation causing bone distortion
Patient movement during exposure
Incorrect centering cutting important areas

Solution: Ensure adequate abduction and complete hand supination

Special Considerations

Trauma Patients

If patient cannot abduct arm, position as tolerated and document limitation.

Obese Patients

Increase kV and mAs according to thickness adjustment table.

Geriatric Patients

Consider mobility limitations, possible need for seated position.

Clinical Indications

Humeral diaphysis fractures

Deformity evaluation

Humeral bone tumors

Complete arm trauma