Revision 4 for 'Shoulder (AP glenoid view)'

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Shoulder: AP glenoid

The shoulder AP glenoid view is an additional projection to the two view shoulder series. The projection is used to asses the integrity of the glenohumeral joint.

Patient position

  • 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 center of the image receptor
  • patient is turned toward the affected side in order to show the glenohumeral joint space, this is achieved by rotating the patient 30-45°
  • affected arm is internally rotated

Technical factors

  • 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 1/3 of the medial clavicle
  • orientation  
    • portrait
  • detector size
    • 18 cm x 24 cm
  • exposure
    • 60-70 kVp
    • 10-18 mAs
  • SID
    • 100 cm
  • grid
    • yes (this can vary departmentally)

Image technical evaluation

  • the gelnohumeral joint should be open
  • the anterior and posterior aspects of the glenoid are superimposed
  • the coracoid process is foreshortened
  • no foreshortening of the scapular body (as per the patient rotation discussed in the positioning)

Practical points

Rotation of the patient will vary due to body habitus, this is an obvious point but highly relevant. Patients who require these films are often suffering from either chronic or acute shoulder pain and palpating the affected shoulder is far from ideal. It's advisable to observe the clavicle when rotating the patient until the mid shaft of the clavicle is almost end on.

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