An inferosuperior axial projection (Clements modification) is performed on a patient with a nontraumatic shoulder injury.The patient cannot fully abduct the upper limb 90°.Which of the following modifications of the position should be performed for this patient?

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Quizplus · Accepted Answer

In an inferosuperior axial projection (Clements modification), the central ray is angled 5 to 15° toward the axilla. This projection is most commonly used to visualize the glenoid cavity and the scapulohumeral joint. If the patient cannot fully abduct the upper limb 90°, angling the central ray 5 to 15° toward the axilla helps to open up the joint space and improve visualization. Angling the central ray 30° toward the axilla (choice A) or 45° toward the elbow AC joint separation (choice C) is not necessary and may result in poor visualization. Similarly, rotating the shoulder slightly anteriorly to open up the joint space (choice D) may not be feasible for a patient with a nontraumatic shoulder injury who cannot fully abduct their arm.

An Inferosuperior Axial Projection (Clements Modification) Is Performed on a Patient