Shoulder Xrays

  • True AP of GHJ
    • AP at 30-45° to sagittal plane with plate behind scapula
    • Can be done with IR, neutral, ER to look for calcific tendonitis
    • Can be done with full IR to show Hill-Sach’s lesion
  • Axillary Lateral
    • Abduction of shoulder to 90° with beam aimed through the axilla
    • Shows orientation of humeral head with glenoid
    • Can also be useful in acute trauma with only 20° shoulder abduction
  • Scapular Lateral (Y-scapular, transverse scapular)
    • If axillary view not possible
    • Beam from posterior along line of scapula to plate held perpendicular to scapular spine over front of shoulder
  • Garth
    • AP beam aimed 45° laterally in coronal plane & 45° caudal in transverse plane to plate held behind the shoulder
    • Visualises the anterior & anteroinferior rim of the glenoid & shows bony Bankart lesions
  • West-Point
    • Patient prone with arm hanging off bed & plate superior to shoulder
    • Beam aimed 25° caudal to transverse plane & 25° lateral to sagittal plane
    • Visualises the anterior & anteroinferior rim of the glenoid & shows bony Bankart lesions
  • Stryker Notch
    • Patient supine with shoulder flexed with affected hand on head
    • Beam then directed in AP plane with 10° cephalad tilt
    • Displays Hill-Sach’s lesion
  • Supraspinatus Outlet
    • Similar set-up as Y-scapular with posterior-to-anterior beam with 5-10° caudal tilt
    • Delineates morphology of acromion
  • Anterior Acromial
    • AP of GHJ with 30° caudal tilt
    • Visualises subacromial spurs
  • ACJ
    • AP with 10° cephalad tilt
    • Stress view with 10-20lb weight suspended from wrists
  • Serendipity
    • AP view of SCJ with patient supine with beam directed in 40° cephalic tilt
    • Useful for SCJ dislocation but CT often gives more information