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Shoulder Xray

True AP Shoulder in neutral rotation

True AP Shoulder in neutral rotation (taken in the plane of the scapula) (Grashey view)

Blue dot = Greater Tuberosity
Red dot = Lesser Tuberosity

Position:  Patient erect, turned 30-35° toward the side being xrayed
Tube: Perpendicular to plate

AP Shoulder in External rotation

AP Shoulder in External rotation (taken in the plane of the scapula)

Blue dot = Greater Tuberosity
Red dot = Lesser Tuberosity

 

 

 

 

Position:  Patient erect, turned 30-35° toward the side being xrayed; arm maximally externally rotated
Tube: Perpendicular to plate

AP Shoulder in Internal rotation xray

AP Shoulder in Internal rotation (taken in the plane of the scapula)

Blue dot = Greater Tuberosity
Red dot = Lesser Tuberosity

 

 

Position:  Patient erect, turned 30-35° toward the side being xrayed; arm maximally internally rotated

Beam: aimed perpendicular to plate

Scapular Y Shoulder Xray

Scapular Y Shoulder Xray

Position: Erect with anterior aspect of affected shoulder against x-ray plate and rotating other shoulder out 40 deg°.

Beam: aimed from posteriorly along scapular spine

Axillary view Shoulder Xray

Axillary view Shoulder Xray

Position: Patient seated at side of radiographic table with the arm abducted and axilla over the cassette.

Beam:angle 5°-10° toward the elbow, central beam directed at the shoulder joint.

Many alternative postions for similar xray, can be supine etc.

Supraspinatus Outlet view Shoulder Xray

Supraspinatus Outlet view Shoulder Xray

 

Position: Erect with anterior aspect of affected shoulder against x-ray plate and rotating other shoulder out 40 deg°.

Beam: aimed from posteriorly along scapular spine but with the beam aimed with 10° caudal tilt

Zanca View Shoulder Xray

Zanca View Shoulder Xray

Position: Erected with cassette behind shoulder.

Beam:Xray beam aimed at the AC joint in 10° to 15° cephalic tilt. Xray penetration should be 1/2 normal to avoid overpenetration of AC joint.

West Point Axillary View Shoulder Xray

West Point Axillary View Shoulder Xray

Postion:Patient prone with affected shoulder resting on a pad @8cm for the table top. Casette positioned against the superior apsect of the shoulder.

Beam: aimed 25° from horizontal (to tables surface) and 25° medially (to patients midline).

 

(Rokous JR, CORR 1972;82:84)

Stryker Notch View Shoulder Xray

Stryker Notch View Shoulder Xray

Position: Patient supine with cassette posterior to the shoulder. The hand placed on top of the head. The elbow should point straight upward.

Beam directed 10° superiorly/toward the head, centered over the coracoid process.

 

(Hall RH, JBJS 1959;41-A:489-94)

Serendipity View Shoulder Xray

Serendipity View Shoulder Xray

Postion: supine with cassette under upper chest
Beam aimed at clavicle or manubrium (SC pathology) with a 40° cephalic tilt.

 

Bennett's View (modified)Shoulder Xray

  • Obtained by angling the tube 5° cephalad with the arm abducted 45°. Approximates an AP in ER view.
  • Wright RW, AJSM 2004;32:121       
Bennett's view Shoulder Xray

Bennett's view Shoulder Xray

  • External rotation of the humerus with tilting of the x-ray tube 5° cephalad
  • Bennett GE: Elbow and shoulder lesions of baseball players. Am J Surg 98: 484–492, 1959       
Acromiohumeral Interval

Acromiohumeral Interval

  • average = 10.5mm. <7mm=full-thickness RTC tear. Measure on Grashey view. (Cotty P, J Radiol 1988;16:633).       
Garth view

Garth View (apical oblique) Shoulder Xray

Postion: Seated with shoulder adjacent to cassette and arm adducted and internally rotated (place hand over heart). Chest rotated 45º

Beam: beam perpendicular to the anterior-inferior glenoid rim and posterior-superior humeral head. (45º to the coronal plane and 45º caudally).

Rollover for example rendition.

Garth WP Jr, JBJS1984;66A:1450

 

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