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Citation, DOI & article dataCitation: Murphy, A. Shoulder (lateral scapula view). Reference article, Radiopaedia.org. (accessed on 08 Sep 2022) https://doi.org/10.53347/rID-48252 The lateral scapula shoulder or Y view is part of the standard shoulder series. On this page:Orthogonal to the AP shoulder (note: as is an axillary view); this view is a pertinent projection to assess suspected dislocations, scapula fractures, and degenerative changes. It is also useful in seeing both the coracoid and acromion process in profile.
The lateral scapula projection can be technically demanding, especially when patients are in pain. An anecdotal method amongst radiographers is to feel for the medial border of the scapula and line it up with the anterior portion of the acromion and x-ray straight down the line. The idea being, if they are lined up there will be a superimposition of the medial and lateral borders of the scapula and hence a perfect lateral position, although this isn't always the case. The best defense against positional errors is having a thorough understanding of radiographic anatomy and how it changes positionally when assessing for under/over rotation of the lateral shoulder, assess the borders of the scapula. Over rotationOver rotation in this projection refers to the patient's unaffected side sitting too far away from the image receptor, otherwise known as lying ‘too square’ to the detector. Over-rotation is clearly established as the lateral border of the scapula (significantly thicker than the medial) is projected over the thorax along with the humeral head; to adjust this, rotated the unaffected side towards the image receptor slightly. Under rotationUnder rotation in this projection refers to the patient's unaffected side sitting too close to the image receptor, otherwise known as lying ‘flat’ to the detector. The lateral border, as well as the humeral head, will be sitting overly lateral in the image; to fix this, rotated the unaffected side away from the detector to increase obliquity. Some departments will recommend a 15-degree caudal angle to achieve the ‘perfect’ lateral shoulder; it should be noted this is an entirely different projection known as an ‘outlet projection’ used primarily for the visualization of the supraspinatus outlet; often aiding in the investigation of impingement, spurs and calcifications. ReferencesRelated articles: Imaging in practicePromoted articles (advertising)Where is the central ray for the scapular Y projection of the shoulder?Central ray: The central ray should be perpendicular to the image receptor directed to the glenoid fossa or 2 inches medial and 2 inches inferior to the superolateral border of the shoulder.
How many degrees is the body rotated for the AP oblique projection of the shoulder joint?The AP oblique Grashey view is obtained with the patient rotated 35-45 degrees and his or her back (scapular body) up against the imaging detector.
How much should the patient be obliques for a scapular Y position of the shoulder?Rotate into an anterior oblique position as for a lateral scapula with patient facing IR. Average patient will be in 45degree to 60degree anterior oblique position. Palpate scapular borders to determine correct rotation for a true lateral position of scapula. Center scapulohumeral joint to CR and to center of IR.
For which projection of the shoulder girdle is the patient positioned with his her Midcoronal plane forming an angle at 45 to 60 degrees to IR?Cards
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What anatomy is superimposed over the junction of the Y on the PA oblique scapular Y projection on a patient with a normal shoulder joint?
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