LRA 218 Final Exam 2026/2027
Comprehensive Questions and Verified
Answers with Rationales
SECTION 1: SHOULDER AND PROXIMAL HUMERUS (Questions 1-50)
Question 1:
What is the common term for idiopathic chronic adhesive capsulitis?
Answer: Frozen Shoulder
Rationale: Idiopathic chronic adhesive capsulitis is clinically referred to as "frozen
shoulder." This condition involves inflammation and thickening of the shoulder
joint capsule, leading to pain and restricted movement. The term "frozen" describes
the characteristic stiffness and loss of range of motion that patients experience .
Question 2:
Which AP shoulder projection demonstrates the lesser tubercle in profile medially?
Answer: Internal Rotation
Rationale: In the internal rotation AP projection of the shoulder, the humerus is
rotated internally, which brings the lesser tubercle into profile on the medial aspect
of the humeral head. This positioning is essential for visualizing specific
anatomical structures and detecting potential fractures or abnormalities .
Question 3:
For AC joint weight-bearing studies, should patients hold weights with their hands
or have weights attached to their wrists?
Answer: Weights should be attached to the wrist
,Rationale: During AC joint weight-bearing studies, patients should not grip
weights with their hands because this activates the shoulder musculature and can
alter the joint space appearance. Attaching weights to the wrists allows gravity to
stress the AC joint without muscular contraction interference, providing a more
accurate assessment of joint space width .
Question 4:
True or False: A posterior dislocation of the shoulder occurs more frequently than
an anterior dislocation.
Answer: False
Rationale: Anterior shoulder dislocations are significantly more common than
posterior dislocations, accounting for approximately 95% of all shoulder
dislocations. Posterior dislocations are relatively rare, comprising only 2-4% of
shoulder dislocations, and are often associated with seizure activity or electrical
injury .
Question 5:
Is sonography an effective diagnostic tool for studying the shoulder joint?
Answer: True
Rationale: Sonography (ultrasound) is indeed an effective diagnostic modality for
evaluating shoulder joint pathology. It provides real-time dynamic assessment of
rotator cuff tendons, the biceps tendon, and can detect tears, tendinopathy, and joint
effusion without radiation exposure .
Question 6:
A radiograph of an AP axial projection of the clavicle demonstrates that the
clavicle is within the mid-aspect of the lung apices. What should the technologist
do to correct this error?
Answer: Increase the cephalic CR angle during repeat exposure
,Rationale: When the clavicle appears within the mid-aspect of the lung apices on
an AP axial projection, this indicates that the central ray angle was insufficient.
Increasing the cephalic angle of the central ray will project the clavicle superiorly
to its proper position above the lung apices .
Question 7:
The AP humerus requires that the humeral epicondyles are to the IR.
Answer: Parallel
Rationale: For an AP projection of the humerus, the humeral epicondyles must be
parallel to the image receptor to ensure the humerus is in true AP position. This
positioning eliminates rotation and provides an accurate anatomical
representation .
Question 8:
A patient enters the department with multiple injuries including a possible fracture
of the left proximal humerus. Which positioning routine should be performed?
Answer: AP and horizontal beam transthoracic lateral shoulder projection
Rationale: For trauma patients with suspected proximal humerus fractures, the AP
projection should be performed along with a horizontal beam transthoracic lateral
projection. The horizontal beam technique allows for imaging without moving the
injured extremity, reducing the risk of further injury while still providing
diagnostic images .
Question 9:
A lateral elbow radiograph demonstrates about half of the radial head
superimposed by the coronoid process of the ulna. Which of the following
occurred?
Answer: No positioning errors occurred
, Rationale: In a properly positioned lateral elbow, it is normal to see approximately
half of the radial head superimposed by the coronoid process of the ulna. This
appearance indicates correct positioning and does not represent an error .
Question 10:
A radiograph of the elbow demonstrates the radius directly superimposed over the
ulna and the coronoid process in profile. Which projection has been performed?
Answer: Medial rotation oblique
Rationale: When the radius is directly superimposed over the ulna and the
coronoid process appears in profile, this indicates a medial rotation oblique
projection of the elbow. This positioning is used to evaluate specific elbow
structures that are not well visualized in other projections .
Question 11:
Which routine projection of the elbow will best demonstrate an elevated or visible
posterior fat pad?
Answer: True lateral with 90º flexion
Rationale: The true lateral projection of the elbow with 90 degrees of flexion is
the optimal projection for demonstrating a posterior fat pad sign. The fat pad
becomes visible when joint effusion displaces the fat, which is best appreciated in
this projection .
Question 12:
Which projection can be performed using a breathing technique?
Answer: Scapular Y lateral projection
Rationale: The scapular Y lateral projection can be performed using a breathing
technique. This technique involves having the patient breathe during exposure,
which helps blur overlying soft tissue and lung markings that could obscure the
scapular anatomy .
Comprehensive Questions and Verified
Answers with Rationales
SECTION 1: SHOULDER AND PROXIMAL HUMERUS (Questions 1-50)
Question 1:
What is the common term for idiopathic chronic adhesive capsulitis?
Answer: Frozen Shoulder
Rationale: Idiopathic chronic adhesive capsulitis is clinically referred to as "frozen
shoulder." This condition involves inflammation and thickening of the shoulder
joint capsule, leading to pain and restricted movement. The term "frozen" describes
the characteristic stiffness and loss of range of motion that patients experience .
Question 2:
Which AP shoulder projection demonstrates the lesser tubercle in profile medially?
Answer: Internal Rotation
Rationale: In the internal rotation AP projection of the shoulder, the humerus is
rotated internally, which brings the lesser tubercle into profile on the medial aspect
of the humeral head. This positioning is essential for visualizing specific
anatomical structures and detecting potential fractures or abnormalities .
Question 3:
For AC joint weight-bearing studies, should patients hold weights with their hands
or have weights attached to their wrists?
Answer: Weights should be attached to the wrist
,Rationale: During AC joint weight-bearing studies, patients should not grip
weights with their hands because this activates the shoulder musculature and can
alter the joint space appearance. Attaching weights to the wrists allows gravity to
stress the AC joint without muscular contraction interference, providing a more
accurate assessment of joint space width .
Question 4:
True or False: A posterior dislocation of the shoulder occurs more frequently than
an anterior dislocation.
Answer: False
Rationale: Anterior shoulder dislocations are significantly more common than
posterior dislocations, accounting for approximately 95% of all shoulder
dislocations. Posterior dislocations are relatively rare, comprising only 2-4% of
shoulder dislocations, and are often associated with seizure activity or electrical
injury .
Question 5:
Is sonography an effective diagnostic tool for studying the shoulder joint?
Answer: True
Rationale: Sonography (ultrasound) is indeed an effective diagnostic modality for
evaluating shoulder joint pathology. It provides real-time dynamic assessment of
rotator cuff tendons, the biceps tendon, and can detect tears, tendinopathy, and joint
effusion without radiation exposure .
Question 6:
A radiograph of an AP axial projection of the clavicle demonstrates that the
clavicle is within the mid-aspect of the lung apices. What should the technologist
do to correct this error?
Answer: Increase the cephalic CR angle during repeat exposure
,Rationale: When the clavicle appears within the mid-aspect of the lung apices on
an AP axial projection, this indicates that the central ray angle was insufficient.
Increasing the cephalic angle of the central ray will project the clavicle superiorly
to its proper position above the lung apices .
Question 7:
The AP humerus requires that the humeral epicondyles are to the IR.
Answer: Parallel
Rationale: For an AP projection of the humerus, the humeral epicondyles must be
parallel to the image receptor to ensure the humerus is in true AP position. This
positioning eliminates rotation and provides an accurate anatomical
representation .
Question 8:
A patient enters the department with multiple injuries including a possible fracture
of the left proximal humerus. Which positioning routine should be performed?
Answer: AP and horizontal beam transthoracic lateral shoulder projection
Rationale: For trauma patients with suspected proximal humerus fractures, the AP
projection should be performed along with a horizontal beam transthoracic lateral
projection. The horizontal beam technique allows for imaging without moving the
injured extremity, reducing the risk of further injury while still providing
diagnostic images .
Question 9:
A lateral elbow radiograph demonstrates about half of the radial head
superimposed by the coronoid process of the ulna. Which of the following
occurred?
Answer: No positioning errors occurred
, Rationale: In a properly positioned lateral elbow, it is normal to see approximately
half of the radial head superimposed by the coronoid process of the ulna. This
appearance indicates correct positioning and does not represent an error .
Question 10:
A radiograph of the elbow demonstrates the radius directly superimposed over the
ulna and the coronoid process in profile. Which projection has been performed?
Answer: Medial rotation oblique
Rationale: When the radius is directly superimposed over the ulna and the
coronoid process appears in profile, this indicates a medial rotation oblique
projection of the elbow. This positioning is used to evaluate specific elbow
structures that are not well visualized in other projections .
Question 11:
Which routine projection of the elbow will best demonstrate an elevated or visible
posterior fat pad?
Answer: True lateral with 90º flexion
Rationale: The true lateral projection of the elbow with 90 degrees of flexion is
the optimal projection for demonstrating a posterior fat pad sign. The fat pad
becomes visible when joint effusion displaces the fat, which is best appreciated in
this projection .
Question 12:
Which projection can be performed using a breathing technique?
Answer: Scapular Y lateral projection
Rationale: The scapular Y lateral projection can be performed using a breathing
technique. This technique involves having the patient breathe during exposure,
which helps blur overlying soft tissue and lung markings that could obscure the
scapular anatomy .
