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shoulder xray

Shoulder X-ray views

Epomedicine, Jan 2, 2021Aug 7, 2024

Last updated on August 7, 2024

Shoulder X-ray views

AP Shoulder: in plane of thorax

AP in plane of scapula: Angled 45 degrees lateral

  • Neutral rotation: Grashey view (estimation of glenohumeral space)
  • Internal rotation/External rotation 30 degrees: Hill sach’s lesion and other humeral head morphology
grashey view
Grashey view

Scapular Y lateral: Erect with opposite shoulder rotated 40 degrees out and beam centered on spine of scapula (shoulder dislocations and scapula fractures)

scapular y view
Berritto, Daniela & Pinto, António & Russo, Anna & Urraro, Fabrizio & Laporta, Antonella & Belfiore, Maria Paola & Grassi, Roberto. (2018). Scapular fractures: A common diagnostic pitfall. Acta bio-medica : Atenei Parmensis. 89. 102-110. 10.23750/abm.v89i1-S.7014. [CC BY-NC-SA 4.0]

Supraspinatus outlet view: Scapular Y view with beam caudally tilted 10 degrees (Acromion morphology)

Axillary views:

  • Standard axillary (Lawrence): Supine; arm abducted 90 degrees; beam inferior to superior, 15 to 30 degrees medial angulation depending on abduction
  • West Point axillary: Prone; arm abducted 90 degrees and hanging over the table edge; beam angulated 25 degrees medially and anteriorly (detect Bankart fractures)
  • Velpeau: Standing; wearing arm sling, leans backward over table 30 degrees; beam directed superior to inferior
  • Trauma axillary lateral: Supine; arm supported in 20 degrees flexion by placing radiolucent material under elbow
westpoint view
INFEROSUPERIOR AXIAL SHOULDER X-RAY – RadTechOnDuty [CC BY-NC-ND]

Apical Oblique (Garth view): Grashey (True AP) view with beam 45 degrees caudally (to show anterior/inferior capsule; bony bankart/Hill Sachs)

Garth view
INFEROSUPERIOR AXIAL SHOULDER X-RAY – RadTechOnDuty [CC BY-NC-ND]

Stryker-notch view: Supine; palm on head with elbow straight up; beam directed AP with 10 degrees cephalic aiming coracoid (Hill Sachs)

Stryker notch view
Kostretzis, Lazaros & Theodoroudis, Ioannis & Boutsiadis, Achilleas & Papadakis, Nikolaos & Papadopoulos, Pericles. (2017). Suprascapular Nerve Pathology: A Review of the Literature. The Open Orthopaedics Journal. 11. 140-153. 10.2174/1874325001711010140. [CC BY 4.0]

Zanca view: Erect; Beam centered on AC joint with 10 degrees cephalic tilt and 50% exposure (AC Joint)

Serendipity view: Supine; Beam centered on clavicle/manubrium with 40 degrees cephalic tilt (SC Joint)

sternoclavicular joint views

Hobb’s view (90 degree cephalocaudal lateral): Sitting; Leans forward so that the anterior chest is in contact with film cassette & the flexed elbows straddle the cassette & support the patient; X-ray beam is directed directly down


For specific pathologies

a. Obligatory: AP, Lateral or axillary

b. Subacromial impingement: “Y” view

c. Coracoid impingement: Axillary, Lateral

d. Scapular pathology: “Y” view

e. Bankart: Garth view, West point view

f. Hill Sach’s: Stryker notch view, AP with Internal rotation

g. Glenohumeral arthritis: True AP in internal and external rotation and Axillary lateral view

h. Sternoclavicular pathology: Serendipity view, Hobb’s view

i. Acromioclavicular pathology: Zanca view; Stress view with 5 kg weight suspended on wrist and showing both shoulders

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PGMEE, MRCS, USMLE, MBBS, MD/MS Musculoskeletal systemOrthopedicsRadiology

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Epomedicine. Shoulder X-ray views [Internet]. Epomedicine; 2021 Jan 2 [cited 2025 May 8]. Available from: https://epomedicine.com/medical-students/shoulder-x-ray-views/.

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