Shoulder X-ray positioning

How to position for each of the 8 shoulder X-ray views: where the patient goes, where to centre, which receptor and distance to use, and what a good image looks like.

By the ScanFlo Editorial Team · Updated 6 October 2026

X-ray positioning/Shoulder

The routine shoulder views are Clavicle AP (two angled views), Scapula AP, Scapula lateral and Shoulder AP (two rotations). Acromioclavicular joint AP, Shoulder AP (after injury), Shoulder axial and Shoulder lateral (scapular Y) come in when you need to answer a particular question, or when the patient can't manage a routine view. Each guide walks you through the set-up step by step, with a short video, exposure settings for different patient sizes and what a good image should show.

A radiographer is still checking these guides.

Routine views

Clavicle AP (two angled views) →Supine · 100 cm · centring point: the mid-clavicle

Scapula AP →Supine · 100 cm · centring point: 5 cm below the coracoid

Scapula lateral →Oblique, erect · 110 cm · centring point: the medial border of the scapula

Shoulder AP (two rotations) →Supine · 100 cm · centring point: the coracoid process

Extra views

Acromioclavicular joint AP →Supine · 100 cm · centring point: the acromioclavicular joint

Shoulder AP (after injury) →Sitting · 110 cm · centring point: the coracoid process

Shoulder axial →Sitting · 100 cm · centring point: the glenohumeral joint from above

Shoulder lateral (scapular Y) →Oblique, erect · 110 cm · centring point: the medial border of the scapula at the humeral head

All views in this region

• Clavicle AP (two angled views)
• Scapula AP
• Scapula lateral
• Shoulder AP (two rotations)
• Acromioclavicular joint AP
• Shoulder AP (after injury)
• Shoulder axial
• Shoulder lateral (scapular Y)

Quick reference

Where to centre, how far and which receptor, for every shoulder view at a glance. Open a guide for the full set-up.

Mistakes that lead to repeats

• Fracture hidden by ribs on the clavicle AP (two angled views): take both angled views.
• Inferior angle cut off on the scapula AP: centre lower.
• Scapula over the ribs on the scapula lateral: turn the trunk further.
• Joint space closed on the shoulder AP (two rotations): pad the other shoulder.
• Joint obscured on the acromioclavicular joint AP: reduce exposure for soft bone.
• Arm moved on the shoulder AP (after injury): leave the arm in its sling.

Common questions

Which shoulder views are routine?

Usually Clavicle AP (two angled views), Scapula AP, Scapula lateral and Shoulder AP (two rotations).

What distance (SID) do shoulder X-rays use?

Anywhere from 100 to 110 cm, depending on the view. Each guide gives the exact figure.

Do shoulder X-rays need a grid?

Most do. The exceptions, taken without a grid, are Shoulder axial.

← All positioning regions