Shoulder (modified trauma axial view)

Mr Andrew Murphy et al.

The modified trauma axial view is a supplementary projection that replaces the ‘Y view’ of the two-view shoulder series often performed in the context of trauma.

It is an orthogonal view of the AP projection of the glenohumeral joint, with a higher diagnostic yield than the lateral scapular shoulder view.

It is a valuable view for assessing the articulations of the shoulder and the relationship of the humeral head with the glenoid.

  • the patient is supine or seated

  • affected arm is placed beside the patient, if possible externally rotate

  • the detector is placed under the patient running parallel to the thorax

  • axial projection

  • centring point

    • glenohumeral joint with a 45° caudal angle

  • 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 distal third of the clavicle

  • orientation  

    • portrait

  • detector size

    • 18 cm x 24 cm

  • exposure

    • 60-70 kVp

    • 10-17 mAs

  • SID

    • 100-150 cm

  • grid

    • no

Slightly magnified (due to subject field distance).

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

This projection has been proven to be as diagnostically relevant as the lateral ‘Y’ view in trauma. Studies have shown that if it replaced the ‘Y’ view, no abnormalities would be overlooked.

In trauma, this projection can be utilised on the supine patient with little to no effort on the patient's behalf, although it can get tricky with the subject-to-film distance and magnification.

Remember to adjust your exposure in accordance with your angle; a steeper angle means the x-ray needs to penetrate through more tissue.

The humeral head will be displaced superior to the glenoid if it is a posterior dislocation and inferior if it is anterior

Radiographic views
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Article Information

rID: 48955
Section: Radiography
Tag: snippet
Synonyms or Alternate Spellings:

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