What views would be most appropriate for assessment of the shoulder, if you suspect impingement?
Alex Brenner PT MPT OCS -> Re: XRAY views for shoulder (January 20, 2005 1:47:00 AM)
Hi Julie. There are probably several answers to this question. I think the textbook answers is that there are three recommended views. The anteroposterior view with the arm at 30 degrees external rotation, the outlet Y view and the axillary view.
The outlet Y view is useful because it shows the subacromial space and can differentiate the acromion processes. A lateral view of the scapula will also do this. With shoulder impingment you certainly want to examine the acromion. Type II and Type III acromions are typically a "hooked" type and can decrease the subacromial space. From these veiws you can also assess if there is a subacromial spur present that may be causing symptoms. Interestingly I have seen subacromial spurs on younger soldiers when you would not expect to find one. I guess it is not always reserved for patients with DJD of the AC joint . I dont have a good picture of the outlet y view but if I come across one I will post it. I hope this helps.
As a chiropractor, I will usually take 2 AP views, enternal and external rotation. This views will give an adequate view of the AC and GH joint spaces. Shoulder x-rays for impingement normally yields poor results (unfortunately), but it still helps to rule out spurring, DJD, etc.