A Study of Patient Position Indices for Accurate Radiography in Glenohumeral Joint Projection [Grashey method]

Abstract

Purpose: The purpose of the present paper is to offer the meniscus shadow distance and image anatomical values of the scapular pole and scapular body according to gender and age, and to provide anatomical indicators for radiological technologists to easily create accurate glenohumeral joint images regardless of the patient's shoulder shape.

Materials and methods: This study retrospectively examined 200 left shoulder joint anteroposterior projection and superoinferior axial projection images of patients who visited a general hospital in Seoul from December 1 to December 31, 2023, with shoulder joint pain. The researcher measured the Halfmoon sign distance, scapular spine angle, scapular plane angle, and scapular body angle, and compared and analyzed the difference in mean values and correlation between each variable.

Results: The average value of the Halfmoon sign distance was 12.08±4.18 ㎜, and males were found to be about 3 ㎜ larger than females, but there was no statistically significant difference according to age. The average scapular spine angle was 15.95±13.20°, and when comparing the average values by gender, females were about 1° larger than males. When compared by age groups, those in their 30s had the smallest at 11.17±4.00°, followed by those in their 20s and younger and those in their 60s; The 70s were measured at similar angles. The average scapular plane angle was 41.04±8.74°, and the difference by gender was not statistically significant, but the difference by age was lowest in those in their 50s and highest in those in their 70s or older. The average scapular body angle was measured at 57.00±11.06°, and the difference between genders was about 3° larger in females than in males, but there was no statistically significant difference. Differences by age showed the largest angle in the 70s or older group and the smallest angle in the 30s group. The correlation results between each measurement showed a weak positive correlation between Halfmoon sign distance, scapular spine angle, scapular plane angle, and scapular body angle. Still, the scapular spine angle showed a strong positive correlation with the scapular plane angle and scapular body angle.

Conclusion: As a result of this study, the average size of the Halfmoon sign distance was 12.08 ± 4.18 mm, the scapular spine angle was 15.95 ± 13.20°, the scapular plane angle was 41.04 ± 8.74°, and the scapular body angle was 57.00 ± 11.06°. During glenohumeral joint projection, it is believed that positioning the scapular spine so that it is level with the image receptor will help produce accurate glenohumeral joint images