Tuesday, March 22, 2011

X-rays for shoulder arthritis

In the normal shoulder, the ball of the humeral head and the glenoid socket of the scapula are covered with smooth articular cartilage. This cartilage gives the joint a coefficient of friction less than that of an ice skate on ice. It is this cartilage that is destroyed in shoulder arthritis.
Cartilage cannot be seen on X-rays, but the thickness of cartilage can be detected by observing the separation of the bones, the 'radiographic joint space'.
In the shoulder, two X-ray views are essential for determining the 'joint space', the AP (anteroposterior) and the axillary views.
An AP view of a normal shoulder looks like this:
and an axillary view of a normal shoulder looks like this:
In each view one can see the separation of the ball from the socket due to the presence of cartilage in this normal right shoulder.
These views must be taken carefully to make sure that poor technique does not hide the true condition of the joint.

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