X-ray of the shoulder joint - a study that allows you to get very accurate information about bone-traumatic and degenerative-dystrophic changes in the largest movable joint of the bones of the hands with the shoulder blade. Diagnosis does not require special preparation, does not take much time and is highly accurate. The study is included in the list of medical procedures and services performed under the compulsory medical insurance policy, it is carried out absolutely free of charge.
What does the x-ray of the shoulder joint
For an accurate diagnosis, medical history and physical examination is not enough. The doctor prescribes additional studies, depending on the pathology.
When x-rays pass through tissues of different densities, the beam scatters and brakes, resulting in an image of different intensities. Radiography is not considered the best way to diagnose soft tissue pathologies. But with diseases of the osteoarticular system, this research method is the main one. In the images, soft tissues are darker and hard ones are lighter.
An x-ray of the shoulder joint in two projections (direct and lateral image) shows a rather detailed picture of pathological changes. In addition to the state of the articulation itself, it can be used to evaluate the condition of the clavicle and scapula. Thanks to the direct projection, the doctor determines the degree of displacement of the fractures (if any), changes in the edges of the acetabulum are clearly visible in the lateral (axial) images.
Indications for radiography of the shoulder joint
Pathologies of the shoulder joint are found not only in surgery, but also in orthopedics and neurology. Patients come with various complaints, and the doctor prescribes an x-ray for the following symptoms:
- Sharp, aching, or shooting pains in the joint area.
- Stiffness in motion.
- Asymmetry of the shoulder area.
- Swelling in the clavicle and shoulder.
- Hyperemia of the skin at the site of the shoulder joint.
In addition to symptoms, there are other indications for the study:
- If you suspect a dislocation of the shoulder joint, an x-ray is the primary diagnostic method.
- Fractures of the humerus, clavicle or scapula.
- Joint diseases of an inflammatory nature (arthritis).
- Pathology of the joints of a degenerative-dystrophic orientation with the destruction of cartilage (arthrosis).
- Suspicion of the occurrence of various neoplasms.
- Control of congenital structural or functional abnormalities of the joint.
Many pathologies of the shoulder joint have similar symptoms and features of the course. Diseases must be differentiated, X-ray allows you to do this quickly and accurately.
Contraindications
Despite the high information content, accessibility and ease of carrying out, in some situations it is necessary to abandon radiography and diagnose diseases by other methods. The reason for this is the presence of contraindications to the procedure. The shoulder joint is not X-rayed if the patient has the following pathological conditions:
- Pregnancy, especially the first trimester.
- Extremely difficult general condition.
- Open pneumothorax.
- Severe bleeding.
- Severe pathology of the liver or kidneys.
- Uncompensated diabetes.
- Pulmonary tuberculosis in an open form.
In modern X-ray machines, ionizing radiation is minimal. Only a doctor can evaluate the possible risks and the appropriateness of the procedure.
How is radiography of the shoulder joint
One of the advantages of radiography is the absence of the need for special training. You can take the test immediately after receiving a doctor, taking his direction. X-ray of the shoulder joint is as follows:
- Cell phones and other emitting gadgets are left outside the office where the diagnostics are carried out.
- Take off outer clothing and metal jewelry. The arm and shoulder are completely exposed.
- Lie down on a special table and occupy a pose optimal for x-ray photography.
- The chest area of the abdomen and pelvis is covered with a lead cloak.
- The doctor brings the emitter to the shoulder and goes into the next room to take the picture. At the time of its holding, the body should be motionless.
- After the procedure, the patient dresses and expects a picture with the explanations of the radiologist in the corridor.
Another advantage of radiography is that the image can be used for consultation at another health facility or other specialist. A record of the procedure is placed in a special book of records, it can be requested at any time.
X-ray damage and precautions
Radiation energy passing through the examined organ of the patient is redirected to the receiver, transforming into an image on film. Unfortunately, some of it “settles” in the patient’s body, contributing to one degree or another to changes at the cellular and tissue levels.
Ionizing radiation can cause radiation burns, the appearance of malignant neoplasms, radiation sickness.
Of course, it is impossible to make an X-ray of the shoulder joint absolutely safe, but protective measures can reduce the degree of radiation damage. There are a number of ways to protect yourself from harmful ionizing radiation:
- Maintaining a special accounting sheet in which data on the frequency of the procedures is entered. Accounting allows you to control radiation dose.
- Compliance with all precautions and recommendations by the patient. When x-ray of the shoulder joint, a special lead apron is put on the patient, leaving only the study area open.
- Development and application of new safer equipment.
- Complete immobility at the time of shooting. If the patient cannot sit still, then the picture may be fuzzy, there will be a need for repeated radiography, which, in turn, increases the dose of radiation.
X-ray value for pathologies of the shoulder joint
In medicine, x-rays have been used for a long time. The study is used to diagnose gastrointestinal diseases, infectious and tumor diseases of the chest, teeth, and female reproductive organs.
Diagnosis is especially important in identifying pathological changes in various departments of the peripheral skeleton. Using an X-ray of the shoulder joint (photo above), fractures, dislocations, diseases of an infectious and tumor nature are revealed. All articulation structures, adjacent soft tissues due to different densities are well visualized, up to the smallest detail. The study is specific, the picture clearly shows which pathology arose in a person.
An x-ray is a flat image of a three-dimensional organ. Therefore, when diagnosing, images should be taken in at least two surfaces. By superimposing images, the localization of the pathological focus can be established. It is almost impossible to do it yourself.
Deciphering the results
Unlike ultrasound images, x-rays are not operator-dependent. Only a specialist can decrypt them.
To understand exactly which deviations were revealed in the image, you need to know what the image looks like after normal x-ray of the shoulder joint. The doctor distinguishes darkening, sees the presence of gaps in the structure of bone tissue, determines its changes, and also accurately identifies the focus of the disease. Norms of indicators:
- The contours of the bones are clear, even. The bone structure is not changed.
- Full conformity to the shape of the contacting articular surfaces.
- Joint cracks are well traced, not narrowed.
- The contours of adjacent surfaces on both sides are clear, even. Bone growths are not noted.
- Bone-dystrophic changes, as well as dystrophic or traumatic, were not detected.
- Soft tissue is not changed.
When viewing a picture, the doctor may ask several questions that will help to understand the causes of the anomalies and correctly prescribe treatment:
- The doctor may ask for a description of the circumstances and the limitations of the injuries.
- Ask if there are any changes in symptoms, and if so, which ones.
- The doctor may conduct a sensitivity test.
The most common pathologies of the shoulder joint
All pathological changes are recorded by the doctor in custody. Pictures are the basis for diagnosis. Translucent of the shoulder joint on x-rays, the following pathologies are revealed:
- Anterior dislocation of the shoulder is the most common structural disorder; it occurs in 98% of cases.
- Back dislocations are rarely diagnosed
- Dislocation with a fracture of the neck of the humerus.
- Inveterate dislocation. Such pathologies are difficult to treat. scars form on soft tissues, muscle tone changes, a degenerative process of muscle tissue develops.
- Rotator cuff injuries.
- Arthrosis.
- Arthritis
- Osteophytes, characterized by the compaction of the capsule and the formation of calcifications in it (deposition of calcium salts).
- Osteoporosis is more often diagnosed in the elderly.
Where to x-ray the shoulder joint
The study is included in the list of free procedures. It will be carried out upon provision of a passport, a compulsory medical insurance policy and directions (if any). Stationary x-ray rooms are in any district clinic.
Private commercial medical institutions rarely provide such a service, with the exception of specialized centers. This is due to the mandatory consideration of ionizing radiation by the patient. But if you consider that the study is required to be carried out as rarely as possible, then it is quite possible to do with the number of stationary rooms.
Conclusion
X-ray of the shoulder joint is the main method for diagnosing pathological changes in this joint. The study allows for a single procedure without preliminary preparation to fully identify the disease or deviation. The method itself is non-invasive, and therefore painless. The only drawback is ionizing radiation, which negatively affects the patient's health.