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AP clavicle X-ray positioning (two angled views)

One of the routine shoulder views. The patient lies on their back, the beam passes front to back (AP), tilted 20° towards the head, and the centring point is the mid-clavicle.

By the ScanFlo Editorial Team · Updated

In this section · X-ray positioning

X-ray positioning/Shoulder

Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.

Patient position

Supine. Supine, arms by the sides. Take one view angled 20° cephalad and one 20° caudad. A child lies on the detector on the table.

Centring & collimation

Central ray

AP

Centre: the mid-clavicle.

Beam: AP, angled 20° cephalad.

Collimate: the whole clavicle with both joints

Distance, receptor & grid

SettingValueNotes
SID100 cm
Receptor24 × 30 cmlandscape
PlacementTable buckyGrid in
Angulation20°cephalad

Marker & breathing

  • Marker: R or L marker on the side nearest the detector
  • Breathing: Suspend respiration.

Exposure by patient size

Treat these as a starting point. Your detector, your generator and the patient in front of you will all move the numbers.

Patient sizekVmAs (chart)mAs (DR default)
XS703.21.25
S7052
M706.32.5
L70104
Child532.51

These start from a classic film-screen chart (70 kV, 12.5 mAs at 140 cm) and are adjusted for a digital detector at 100 cm. The DR column is what ScanFlo's console suggests; each step up or down changes the mAs by about a quarter.

Image quality checklist

  • The whole clavicle including both joints is shown.
  • One view projects the clavicle above the ribs.
  • The anatomical side marker is visible, correct and clear of the anatomy.
  • Collimation borders are visible on all sides, no wider than the area requested.

Faults & how to fix them

FaultCauseFix
Fracture hidden by ribsOnly one projectionTake both angled views.

Common questions

Where do you centre for a clavicle AP (two angled views) X-ray?
The centring point is the mid-clavicle.
What distance and beam angle does a clavicle AP (two angled views) need?
100 cm from the tube to the receptor. The beam passes front to back (AP), tilted 20° towards the head.
What size receptor, and do you need a grid?
Use a 24 × 30 cm receptor, landscape, in the table bucky. A grid is needed.
What should the patient do with their breathing?
Ask them to stop breathing for the moment of the exposure.
What goes wrong most often on a clavicle AP (two angled views)?
Fracture hidden by ribs. Usual cause: only one projection. The fix: take both angled views.

Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a clavicle ap (two angled views) in a 3D room and score your positioning. See ScanFlo XR →

Written by the ScanFlo team from everyday radiographic practice.

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