Shoulder (inferosuperior axial)

Mr Andrew Murphy et al.

The inferosuperior axial view of the shoulder is a modified axial projection best utilised with supine patients. It is an orthogonal projection to the AP view and replaces the lateral shoulder projection.

It is an appropriate projection to assess suspected dislocations, proximal humerus pathology and effective in demonstrating the articular surfaces of the humeral head and glenoid 1-3 .

  • the patient is supine 

  • image receptor is rested upon the superior part of the affected shoulder 

  • the affected arm is abducted as much as achievable 

  • the patient's head is to be tilted away towards the unaffected side 

  • axial projection (inferosuperior)

  • centring point

    • the x-ray tube is in the same plane as the glenohumeral joint shooting inferosuperior 

    • there is a 20-30° medial angle aimed at the glenohumeral joint

  • collimation

    • anterior-posterior to the skin margins 

    • lateral to proximal third of the humerus 

    • medial to include glenohumeral joint

  • orientation  

    • landscape

  • detector size

    • 18 cm x 24 cm

  • exposure

    • 50-60kVp

    • 8-15 mAs

  • SID

    • 100-150 cm

  • grid

    • no

Clear visualisation of the humeral head  (with no superimposition)  and its relationship with the glenoid of the scapula. In addition to the acromion and the coracoid process.

This is an ideal projection when patients are unable to move from the supine position. It can cause patient pain when abducting but nowhere near as much as the standard axial projection

Be wary of your surroundings when moving the x-ray tube in position, there is a high potential of hitting the patients feet. 

Other projections suitable for supine patients that require an orthogonal view of the AP view include: 

 

Radiographic views
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Article Information

rID: 52966
Section: Radiography
Synonyms or Alternate Spellings:
  • Lawrence method

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Cases and Figures

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    Figure 1: inferior superior axial shoulder
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