Lateral Humerus

Complete Lateral Humerus Radiograph

Exposure Factors

60-65

Kilovoltage (kV)

15-20

Milliamperage (mAs)

Fine Focus

Focus Type

105-115 cm

Focus-Plate Distance

Medium exposure: Parameters optimized for lateral visualization of the humerus

Bucky Configuration

With Bucky

Recommended

Better image quality

Without Bucky

Alternative

In special cases or technical limitations

Visible Anatomical Structures

Should be clearly observed:

Complete humerus in lateral projection
Shoulder joint (glenohumeral) in lateral view
Elbow joint in lateral projection
Humeral diaphysis complete without rotation
Proximal and distal epiphysis in true profile
Relationship of humeral condyles

Plate Size and Orientation

30 × 35 cm

Longitudinal

Longitudinal orientation to cover complete humerus from shoulder to elbow

Patient Positioning

Patient in standing position

Anterior part of body in contact with the bucky

Place arm in center of bucky

Arm in sufficient abduction to avoid overlap with other body parts

Flex elbow approximately 90°

Place palm of hand on abdomen

Center humerus in the chassis

Critical Epicondylar Alignment

Key positioning point:

Epicondylar axis perpendicular to chassis

The medial and lateral humeral epicondyles must be aligned perpendicularly to the chassis plane to obtain a true lateral projection.

Central Ray Point

Center of arm

Direction: Horizontal and perpendicular to center of arm

Centered: To center of chassis

Target: Midpoint of humerus between shoulder and elbow

Specific Arm Position

Abduction and Flexion

Arm separated from body

Elbow flexed 90°

Palm on abdomen

Epicondylar Alignment

Epicondylar axis perpendicular to chassis

Avoid arm rotation

Maintain true lateral projection

Patient Instructions

"Do not breathe during exposure"

Maintain position without movement and apnea during radiographic exposure

Special attention in maintaining elbow flexed and palm on abdomen

Optimal Image Characteristics

True lateral view

Complete humerus in profile

Without overlap

Separated from thoracic structures

Visible joints

Shoulder and elbow lateral views

Correct alignment

Epicondyles superimposed

Common Technical Challenges

Frequent problems in lateral humerus projection:

Arm rotation preventing true lateral projection
Insufficient abduction causing overlap with thorax
Incorrect elbow flexion (not 90°)
Poor hand placement (not on abdomen)
Poor epicondylar alignment causing oblique view
Exclusion of joints due to poor chassis placement

Solution: Verify that epicondylar axis is perpendicular to chassis and maintain elbow flexed 90° with palm on abdomen

Adaptations for Patients with Pain

Movement Limitation

Position according to patient tolerance

Document limitations in report

Consider alternative projections if necessary

Geriatric Patient

Consider additional arm support

Position seated if standing is not possible

Adjust exposure time

Specific Clinical Indications

Evaluation of fracture displacement

Foreign body localization

Bone tumor evaluation

Complex arm trauma