AP scapula X-ray positioning
One of the routine shoulder views. The patient lies on their back, the beam passes front to back (AP), straight on to the receptor, and the centring point is 5 cm below the coracoid.
By the ScanFlo Editorial Team · Updated
In this section · X-ray positioning
- X-ray positioning guides
- Skull positioning
- Face & sinuses positioning
- Soft tissue neck positioning
- C-spine positioning
- Chest positioning
- Shoulder positioning
- Humerus positioning
- Elbow positioning
- Forearm positioning
- Wrist positioning
- Hand positioning
- T-spine positioning
- Abdomen positioning
- L-spine positioning
- Sacrum & SI joints positioning
- Pelvis positioning
- Hip positioning
- Femur positioning
- Knee positioning
- Tibia & fibula positioning
- Ankle positioning
- Foot positioning
Still being checked: a radiographer is reviewing this guide. If your department does it differently, follow your department.
Patient position
Supine. Supine with a pillow under the opposite shoulder; the arm abducted slightly to draw the scapula off the ribs.
Centring & collimation
Central ray
APCentre: 5 cm below the coracoid.
Beam: AP, perpendicular to the receptor.
Collimate: the whole scapula
Distance, receptor & grid
| Setting | Value | Notes |
|---|---|---|
| SID | 100 cm | |
| Receptor | 24 × 30 cm | portrait |
| Placement | Table bucky | Grid in |
| Angulation | None | Perpendicular to the receptor |
Marker & breathing
- Marker: R or L marker on the side nearest the detector
- Breathing: Quiet breathing.
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 size | kV | mAs (chart) | mAs (DR default) |
|---|---|---|---|
| XS | 70 | 3.2 | 1.25 |
| S | 70 | 5 | 2 |
| M | 70 | 6.3 | 2.5 |
| L | 70 | 10 | 4 |
| Child | 53 | 3.2 | 1.25 |
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 scapula is clear of the ribs laterally.
- Inferior angle included.
- 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
| Fault | Cause | Fix |
|---|---|---|
| Inferior angle cut off | Centring high | Centre lower. |
Common questions
- Where do you centre for a scapula AP X-ray?
- The centring point is 5 cm below the coracoid.
- What distance and beam angle does a scapula AP need?
- 100 cm from the tube to the receptor. The beam passes front to back (AP), straight on to the receptor.
- What size receptor, and do you need a grid?
- Use a 24 × 30 cm receptor, portrait, in the table bucky. A grid is needed.
- What should the patient do with their breathing?
- They can keep breathing gently; no breath-hold is needed.
- What goes wrong most often on a scapula AP?
- Inferior angle cut off. Usual cause: centring high. The fix: centre lower.
Try it in ScanFlo: the ScanFlo XR X-ray Room, coming soon, lets you set up a scapula ap in a 3D room and score your positioning. See ScanFlo XR →
Written by the ScanFlo team from everyday radiographic practice.