Shoulder (AP view)

Mr Andrew Murphy et al.

The shoulder AP view is a standard projection that makes up the two view shoulder series. The projection demonstrates the shoulder in its natural anatomical position allowing for adequate radiographic examination of the entire clavicle and scapula, as well as the glenohumeral, acromioclavicular and sternoclavicular joints of the shoulder girdle.  

  • patient is preferably erect
  • midcoronal plane of the patient is parallel to the image receptor, in other words, the patient's back is against the image receptor
  • glenohumeral joint of the affected side is at the centre of the image receptor
  • affected arm is in a neutral position by the patient side
  • the patient is slightly rotated 5-10°. Therefore, the body of the scapula is laying parallel with the image receptor
  • anteroposterior projection
  • centring point
    • 2.5 cm inferior to the coracoid process, or 2 cm inferior to the lateral clavicle at the level of the glenohumeral joint
  • collimation
    • superior to the skin margins
    • inferior to include one-third of the proximal humerus
    • lateral to include the skin margin
    • medial to include the sternoclavicular joint
  • orientation  
    • landscape
  • detector size
    • 24 cm x 30 cm
  • exposure
    • 60-70 kVp
    • 10-18 mAs
  • SID
    • 100 cm
  • grid
    • yes (this can vary departmentally)
  • the entire clavicle is visual alongside the glenoid cavity and scapular in the AP position
  • a slight overlap of the humeral head with the glenoid
  • no foreshortening of the scapular body (as per the patient rotation discussed in the positioning)

The technical factors of this examination are not particularly demanding, and there is not much room for positioning error other than over or under rotation to compensate for the scapular body.

An open glenohumeral joint is a sign of over rotation toward the affected side. This results in a more  ‘glenoid AP’ view, and although diagnostically relevant to shoulder pathology, it is not an accurate representation of the surrounding structures.


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Article Information

rID: 45849
Section: Radiography
Synonyms or Alternate Spellings:

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Cases and Figures

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    Figure 1: AP shoulder
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    Figure 2: AP shoulder demonstrating a posterior dislocation
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    Figure 3: acromioclavicular joint injury
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