STUDI KASUS PEMERIKSAAN RADIOGRAFI SHOULDER JOINT KLINIS TRAUMA DI RSUD DR. R SOETIJONO BLORA

Abstrak

Latar Belakang: Sendi bahu merupakan artikulasi yang menghubungkan lengan dengan tubuh. Trauma mengacu pada kondisi ketika tulang terkena benda bergerak atau diam, atau keduanya saat bergerak, sehingga menyebabkan kerusakan jaringan lokal atau efek sistemik. Studi ini bertujuan menentukan teknik pemeriksaan radiografi untuk sendi bahu serta mengidentifikasi informasi anatomi yang diperoleh dari proyeksi posteroanterior (PA) oblique pada sendi bahu dengan rotasi tubuh pasien antara 30° dan 45°. Metode: Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus. Penelitian dilakukan di RSUD Dr. R. Soetijono, Blora, dari Oktober 2021 hingga Juli 2022. Subjek penelitian terdiri dari tiga radiografer dan satu dokter spesialis radiologi. Objek penelitian adalah prosedur pemeriksaan radiografi sendi bahu di rumah sakit tersebut. Data dianalisis menggunakan metode analisis deskriptif. Pengumpulan data dilakukan melalui dokumentasi dan wawancara dengan tiga radiografer serta dokter radiologi terkait prosedur pemeriksaan radiografi sendi bahu di rumah sakit tersebut. Hasil: Berdasarkan pemeriksaan radiografi sendi bahu yang dilakukan di Departemen Radiologi RSUD Dr. R. Soetijono, Blora, tidak ada persiapan khusus pasien yang diperlukan. Proyeksi PA oblique dilakukan dengan pasien dalam posisi tegak atau terlentang, diputar anterior 30°–45° hingga garis scapula imajiner tegak lurus terhadap image receptor (IR). Lengan sedikit diabduksi tanpa rotasi. Central ray (CR) diarahkan secara horizontal dan tegak lurus terhadap IR, dengan jarak sumber ke film (SID) 102 cm dan jarak fokus ke film (FFD) 100 cm. Titik pusat sinar diposisikan pada sendi glenohumeral. Faktor eksposi yang digunakan adalah 56 kV dan 63 mAs. Kolimasi diperlebar agar seluruh area terlihat tanpa terpotong. Informasi anatomi yang tampak pada pemeriksaan radiografi dengan rotasi tubuh 30°–45° mencakup prosesus korakoid yang tampak jelas di bawah klavikula dan akromion yang tampak lateral tanpa superimposisi pada tepi lateral skapula. Dengan rotasi tubuh 45°–55°, struktur anatomi yang terlihat mencakup sendi akromioklavikular, klavikula, prosesus korakoid, dan sendi glenohumeral. Kesimpulan: Teknik pemeriksaan radiografi sendi bahu tidak memerlukan persiapan khusus. Informasi anatomi yang diperoleh dari pencitraan radiografi dengan rotasi tubuh 30°–45° menunjukkan posisi prosesus korakoid di bawah klavikula, akromion tampak lateral tanpa superimposisi, dan batas medial humerus tampak menumpuk dengan tepi lateral skapula.

Background: The shoulder joint is the articulation that connects the arm to the body. Trauma refers to a condition in which a bone is struck by a moving or stationary object, or both in motion, resulting in local tissue damage or systemic effects. This study aims to determine the radiographic examination technique for the shoulder joint and to identify the anatomical information obtained from the posteroanterior (PA) oblique projection of the shoulder joint with patient body rotation between 30° and 45°. Methods: This study employed a qualitative method using a case study approach. It was conducted at RSUD (Regional General Hospital) Dr. R. Soetijono, Blora, from October 2021 to July 2022. The research subjects consisted of three radiographers and one radiology specialist. The object of the study was the radiographic examination of the shoulder joint at the same hospital. Data were analyzed using a descriptive analysis method. Data collection was carried out through documentation and interviews with the three radiographers and the radiologist regarding the radiographic examination procedures for the shoulder joint at the hospital. Results: Based on the radiographic examinations of the shoulder joint conducted at the Radiology Department of RSUD Dr. R. Soetijono, Blora, no special patient preparation was required. The PA oblique projection was performed with the patient in either an erect or supine position, rotated anteriorly by 30°-45° until the imaginary scapular line was perpendicular to the image receptor (IR). The arm was slightly abducted without rotation. The central ray (CR) was directed horizontally and perpendicular to the IR, with a source-to-image distance (SID) of 102 cm and a focal film distance (FFD) of 100 cm. The central point was positioned at the glenohumeral joint. Exposure factors were 56 kV and 63 mAs. Collimation was widened to ensure the entire area was visualized without being cut off. Anatomical information observed in radiographic examinations with patient body rotation of 30°-45° included the coracoid process located below the clavicle and the acromion projected laterally without superimposition on the lateral border of the scapula. With a body rotation of 45°-55°, the visible anatomical structures included the acromioclavicular joint, clavicle, coracoid process, and glenohumeral joint. Conclusion: The radiographic examination technique of the shoulder joint requires no special preparation. Anatomical information obtained from radiographic imaging with patient body rotation of 30°-45° shows the coracoid process positioned below the clavicle, the acromion projected laterally without superimposition, and the medial border superimposed with the lateral border of the scapula.