UPPER LIMBS

RADIOGRAPHIC POSITIONING
TOPICS
■ FINGERS – AP, PA, LATERAL
■ HAND – AP, PA, LATERAL, OBLIQUE, BALL CATCHERS VIEW, BUTTERFLY VIEW
BURMAN METHOD FOLIO METHOD
■ WRIST – AP, PA, LATERAL, OBLIQUE, ULNAR DEVIATION, RADIAL DEVIATION,
CARPAL TUNNEL VIEW – I ,II, CARPAL BRIDGE VIEW
■ FOREARM – AP, LATERAL
■ ELBOW. – AP, LATERAL, ULNAR GROOVE, OLECRANON PROCESS, DISTAL
HUMERUS
■ HUMERUS – AP, LATERAL, TRANS THORACIC LATERAL LAWRENCE METHOD.
■ SHOULDER. – AP, SUPERIOR TO INFERIOR, INFERIOR TO SUPERIOR, STRYKERS VIEW,
CLEMENTS VIEW, RAFFERT VIEW, WEST POINT VIEW, GREYSHAY
VIEW,
GARTH VIEW, TANGENTIAL BICIPITAL GROOVE , VALPEAU VIEW
■ CLAVICLE – AP, PA, INFERIOR TO SUPERIOR, ZANCA VIEW
■ SCAPULA – AP, Y VIEW
FOREARM X RAYS
■ Views:
AP , LATERAL
Trauma view :
PA, TRANSLATERAL

■ INDICATIONS
Trauma
Suspected Fracture
Deformity
Non traumatic pain
Suspected Foreign body
Post operative cases
FOREARM – AP VIEW
AIM
To demonstrate the radius and ulna and soft tissue of Forearm.

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seated near the X ray Couch.
Forearm is placed over 15 x 12 Cassette in supine position including wrist and elbow Joints.
Shoulder is depressed at the level of forearm.
Forearm is adjusted so that both styloid process are at equidistant.
Forearm is immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between wrist and elbow joint.
EXPOSURE FACTOR
KV = 50-52.
MAS = 10-12
. MA = 100.
FFD = 90 CM Collimated
FOREARM – LATERAL VIEW
AIM
To demonstrate the radius and ulna and soft tissue of Forearm.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seated near the X ray Couch.
Affecter Forearm is placed in supine position over the X ray couch. Elbow is flexed 90° and rotated internally.
Hand is perpendicular to the Cassette.
Big Cassette placed under the forearm including wrist and elbow joints.
Shoulder is depressed at the level of forearm.
Forearm is adjusted so that both styloid process are at superimposed.
Forearm is immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between wrist and elbow joint.
EXPOSURE FACTOR
KV = 50-52. MAS = 10-12
. MA = 100. FFD = 90 CM Collimated
TRAUMA PATIENTS > FOREARM – PA VIEW
AIM
To demonstrate the radius and ulna and soft tissue of Forearm.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seated near the X ray Couch.
Forearm is placed over 15 x 12 Cassette in Prone position including wrist and elbow Joints.
Shoulder is depressed at the level of forearm.
Forearm is adjusted so that both styloid process are at equidistant.
Forearm is immobilized
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between wrist and elbow joint.
EXPOSURE FACTOR
KV = 50-52.
MAS = 10-12
. MA = 100.
FFD = 90 CM Collimated
FOREARM – TRANSLATERAL VIEW
AIM
This view is ideal for patients who are unable to move their arm as per the standard forearm positioning
technique but require assessment of suspected radius and/or ulna dislocations or fractures.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seated near the X ray Couch.
Affecter Forearm is placed in Prone position over the Pillow on the X ray couch.
Big Cassette placed on the lateral side of the forearm including wrist and elbow joints.
Shoulder is depressed at the level of forearm..
Forearm is immobilized
CENTERING OF X RAY TUBE
Tube is horizontal so that central ray should pass between wrist and elbow joint.
EXPOSURE FACTOR
KV = 50-52. MAS = 10-12
. MA = 100. FFD = 90 CM Collimated
 COMBINED MONTEGGIA AND GALEAXXI
MONTEGGIA FRACTURE FRACTURE
FOREIGN BODY – FISH BONE PROXIMAL RADIO ULNAR SYNOSTOSIS
ELBOW X RAYS
■ Views:
AP , LATERAL
Axial view :
Ulnar Groove, Distal Humerus, Olecranon process, Jones view, Coyle’s view,

■ INDICATIONS
Trauma
Suspected fracture of the proximal radius and ulna
suspected fracture of the distal humerus
radial head dislocations
deformity
joint effusions
arthritis
ELBOW – AP VIEW
AIM
This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the
elbow joint and soft tissue of the elbow.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Shoulder is depressed at the level of forearm.
Elbow is adjusted so that both epicondyles are at equidistant.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass at 2.5 cm distal end of elbow.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 10-12. FFD = 90 CM Collimated
ELBOW – AP VIEW ( FOREARM CONTACT )
AIM
This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the
elbow joint and soft tissue of the elbow.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Forearm is adjusted so that posterior aspect of forearm contact the Cassette and both epicondyles are at equidistant
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass at 2.5 cm distal end of elbow.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 10-12. FFD = 90 CM Collimated
ELBOW – AP VIEW ( ARM CONTACT )
AIM
This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the
elbow joint and soft tissue of the elbow.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Shoulder is depressed at the level of forearm.
Arm should contact the Cassette and Forearm is slightly raised.
Elbow is adjusted so that both epicondyles are at equidistant
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between two epicondyles.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 10-12. FFD = 90 CM Collimated
ELBOW – LATERAL VIEW ( TYPE 1 )
AIM
This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the
elbow joint and soft tissue of the elbow. Soft tissue of the fat pads should be visible.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is flexed 90° and rotated internally.
The palm of the hand is perpendicular to the couch. Fingers should be overlapped.
Shoulder is depressed at the level of forearm. Elbow is adjusted so that both epicondyles are superimposed.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through lateral epicondyle.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – LATERAL VIEW ( TYPE 2 )
AIM
This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the
elbow joint and soft tissue of the elbow. Soft tissue of the fat pads should be visible.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is flexed 90° and rotated internally.
The palm of the hand is facing the X ray couch.
Shoulder is depressed at the level of forearm.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through lateral epicondyle.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – LATERAL VIEW ( TYPE 3 )
AIM
This view should demonstrate the bones of the elbow and proximal forearm, as well as the distal humerus and the
elbow joint and soft tissue of the elbow. Soft tissue of the fat pads should be visible.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is flexed 90° and rotated internally.
The palm of the hand is facing the outwards.
Shoulder is depressed at the level of forearm.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through lateral epicondyle.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – ULNAR GROOVE VIEW
AIM
To demonstrate the ulnar groove through which ulnar nerve passes.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is fully flexed until the palm of the hand facing the shoulder.
Forearm is slightly abducted.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through medial epicondyle of humerus.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – DISTAL HUMERUS VIEW
AIM
To demonstrate the distal end of humerus, Olecranon process.

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat sideways near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette.
Posterior aspect of forearm should contact the cassette
Elbow rotated internally making the humerus 75° angle from the forearm
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through Olecranon process.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – OLECRANON PROCESS PA AXIAL VIEW
AIM
This view should demonstrate the bones and soft tissue of the elbow joint specifically the olecranon process and
articular margin of the olecranon and humerus.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat sideways near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette.
Posterior aspect of forearm should contact the cassette.
Elbow rotated internally making the humerus 45° angle from the forearm.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 20° inwards so that central ray should pass through Olecranon process.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – JONES VIEW
AIM
To demonstrate the fractures and moderate dislocation of the elbow in acute flexion for the
patients who cannot straighten their arm.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette with forearm acutely flexed.
Elbow is fully flexed until the palm of the hand touches the shoulder.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between two epicondyles of humerus.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – COYLE’S METHOD
AIM
This view should demonstrate the radial head.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is flexed 90° and rotated internally.
The palm of the hand is facing the X ray couch.
Shoulder is depressed at the level of forearm.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 45° inwards ( towards humerus ) so that central ray should pass through
lateral epicondyle.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW – COYLE’S METHOD
AIM
This view should demonstrate the coronoid process.

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient to seat near the X ray Couch.
Affected elbow should be placed over the middle of 10 x 8 Cassette in Supine Position.
Elbow is flexed 90° and rotated internally.
The palm of the hand is facing the X ray couch.
Shoulder is depressed at the level of forearm.
Head of rotated towards the unaffected side.
Elbow is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 45° outwards so that central ray should pass through lateral epicondyle.
EXPOSURE FACTOR
KV = 50-55. MA = 100
MAS = 12-14. FFD = 90 CM Collimated
ELBOW JOINT EFFUSION
DISLOCATION LATERAL EPICONDYLE FRACTURE
GOUTY TOPHUS RHEUMATOID ARTHRITIS
HUMERUS X RAYS
■ Views:
AP , LATERAL
Trauma view :
Transthoracic lateral – Lawrence method

■ INDICATIONS
Trauma
Restriction of abduction
suspected dislocation
suspected bone tumors
HUMERUS – AP VIEW
AIM
This view should demonstrate the bones and soft tissue of the upper arm, specifically the full length of the humerus,
elbow and shoulder joints, and epicondyles.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying supine position over the X ray Couch.
Affected arm and forearm are extended and abducted.
Big Cassette placed under the humerus including elbow and shoulder joints.
Humerus is adjusted so that both epicondyles are at equidistant.
Unaffected side is slightly raised so that the affected side contact the Cassette.
Humerus is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between elbow and shoulder joints.
EXPOSURE FACTOR
KV = 55-60. MA = 100
MAS = 15-20. FFD = 90 CM Collimated
HUMERUS – LATERAL VIEW
AIM
This view should demonstrate the bones and soft tissue of the upper arm, specifically the full length of the humerus,
elbow and shoulder joints, and epicondyles.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying supine position over the X ray Couch.
Affected side forearm is flexed 90° and rotated medially. The palm of the hand is perpendicular to abdomen.
Big Cassette placed under the humerus including elbow and shoulder joints.
Humerus is adjusted so that both epicondyles are at superimposed.
Unaffected side is slightly raised so that the affected side contact the Cassette.
Humerus is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between elbow and shoulder joints.
EXPOSURE FACTOR
KV = 55-60. MA = 100
MAS = 15-20. FFD = 90 CM Collimated
HUMERUS – TRANSTHORACIC LATERAL LAWRENCE VIEW
AIM
This view should be taken for Trauma patients to demonstrate the bones and soft tissue of the humerus and shoulder
including the proximal humerus superimposed with structures of the thorax.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient standing near the chest stand in lateral position.
Big Cassette placed in chest stand upper border above shoulder lower border below elbow joint.
Unaffected side forearm is flexed and palm of the hand touches the back side of head.
Shoulder is elevated as much as possible.Elevation of the uninjured shoulder depresses the shoulder of the injured
side preventing superimposition.
Patient’s midcoronal region should be 90° .Injured arm should be in relax position.
Humerus is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal so that central ray should pass through middle of the humerus.
EXPOSURE FACTOR
KV = 55-60. MA = 100
MAS = 15-20. FFD = 90 CM Collimated
HUMERUS – TRANSTHORACIC LATERAL LAWRENCE VIEW
AIM
This view should be taken for Trauma patients to demonstrate the bones and soft tissue of the humerus and
shoulder including the proximal humerus superimposed with structures of the thorax.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying supine position over the X ray couch.
Upper chest and Affected arm shoulf be raised with the help of pillow.
Big Cassette placed on the lateral Surface of affected arm including shoulder and elbow joint.
Unaffected side forearm is flexed and palm of the hand touches the back side of head.
Shoulder is elevated as much as possible.Elevation of the uninjured shoulder depresses the shoulder of the
injured side preventing superimposition.
Injured arm should be in relax position.
Humerus is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal so that central ray should pass through middle of the humerus.
EXPOSURE FACTOR
KV = 55-60. MA = 100
MAS = 15-20. FFD = 90 CM Collimated
SHOULDER JOINT X RAYS
■ VIEWS
AP, SUPERIOR TO INFERIOR, INFERIOR TO SUPERIOR, STRYKERS VIEW,
CLEMENTS VIEW, WEST POINT METHOD, RAFFERT METHOD, GREYSHAY VIEW,
GARTH VIEW, BICIPITAL GROOVE VIEW, VELPAEU METHOD

■ INDICATION
SHOULDER AP VIEW
AIM
This view should demonstrate the bones and soft tissue of the shoulder.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying supine position over the X ray Couch.
Affected side arm and forearm are extended and abducted.
12 x 10 Cassette placed under the Shoulder joint including medial end of clavicle.
Unaffected side is slightly raised so that the affected side contact the Cassette.
. Head is rotated towards the unaffected side.
Shoulder is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through head of the humerus.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( SUPERIOR TO INFERIOR )
AIM
This view should demonstrate the bones and soft tissue of the shoulder, glenoid fossa, proximal end of humerus,
acromioclavicular joint, outer surface of coracoid process.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient seated sideways near the X ray Couch.
Affected shoulder is placed on the X ray couch and elbow is flexed.
12 x 10 Cassette placed under the Shoulder joint.
OFD ( Object to Film Distance) is reduced.
. Cassette is adjusted so that the head is the humerus and glenoid cavity is included.
Shoulder is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through head of the humerus.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( INFERIOR TO SUPERIOR )
AIM
This view should demonstrate the bones and soft tissue of the shoulder, glenoid fossa, proximal end of humerus,
acromioclavicular joint, outer surface of coracoid process.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying supine position over the X ray Couch.
Affected arm and forearm are extended and abducted.
Affected shoulder is raised and the position is maintained with the help of pillow.
12 x 10 Cassette is placed on the superior side of the Shoulder. Cassette is adjusted including the head of the humerus.
Head is rotated towards the unaffected side.
Shoulder is immobilized.
CENTERING OF X RAY TUBE
Tube is Horizontal and minimal angulation so that central ray should pass through Axilla.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( STRYKERS VIEW )
AIM
This view should demonstrate the bones and soft tissue of the shoulder and the posterosuperior and posterolateral
areas of the humeral head. It is sometimes useful in identifying the cause of shoulder dislocation including dislocations
caused by posterior defects.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying supine position over the X ray Couch.
Affected arm and forearm are flexed and the palm of the hand touches the back side of the head.
12 x 10 Cassette is placed under the Shoulder including glenoid cavity and the head of the humerus.
Head is rotated towards the unaffected side.
Shoulder is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 10-15° so that central ray should pass through Axilla.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( CLEMENTS METHOD )
AIM
This view should demonstrate the bones and soft tissue of the shoulder, glenoid fossa, proximal end of humerus,
acromioclavicular joint, outer surface of coracoid process.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying lateral position over the X ray Couch.
Unaffected side should contact the couch.
12 x 10 Cassette placed on the superior side of the shoulder including the head of the humerus.

Affected side arm and forearm is extended and abducted 90°.

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Prone position over the X ray Couch.
Affected side shoulder is raised with the help of pillow.
12 x 10 Cassette placed on the superior side of the shoulder including the head of the humerus.
Affected side arm and forearm is extended and abducted 90°.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal and tilted 25 °cranially ( towards head ) and 25° medially so that central ray should pass through
Midscapulohumeral joint.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( RAFFERT METHOD )
AIM
To view the Posterolateral humeral head and Hill Sachs lesion.

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Supine position over the X ray Couch.
Affected shoulder is raised with the help of pillow.
12 x 10 Cassette placed on the superior side of the shoulder including the head of the humerus and glenoid cavity.
Affected side arm and forearm is extended and abducted 90°.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal and tilted 15-20° medially so that central ray should pass through acromioclavicular joint.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( GRAYSHEY METHOD )
AIM
To view the Joint space between Humeral head and glenoid cavity.

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand upright position near the Chest stand.
12 x 10 Cassette placed chest stand upper border above the shoulder lower border below Scapula.
Unaffected side raised 45° so that affected side head of the humerus contact the Cassette.
The arm is rotated internally and the palm of the hand touches the abdomen.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal so that central ray should pass through glenoid fossa.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( GARTH METHOD )
AIM
To view the Glenoid cavity and Scapulohumeral joint.

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand upright position near the Chest stand.
12 x 10 Cassette placed chest stand upper border above the shoulder lower border below Scapula.
Unaffected side raised 45° so that affected side shoulder contact the Cassette.
The arm is rotated internally and the palm of the hand touches the abdomen.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal and tilted 45 ° caudally so that central ray should pass through Scapulohumeral Articulation.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( INTERTUBERCULAR GROOVE )
AIM
To view the Bicipital Groove free of superimposition of shoulder joint.

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand near the edge of the X ray couch.
Posterior aspect of the affected side forearm is placed over the X ray couch
12 x 10 Cassette is placed over the anterior surface of the forearm.
Humerus is flexed 10-15° so that the shoulder joint will be at the top of the Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through intertubercular groove.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SHOULDER AXIAL VIEW ( VALPEAU VIEW )
AIM
This projection is performed on patients with a shoulder sling (Velpeau bandage) in place, often in the context
of post-operative or a post-reduction presentation whereby the patient is unable to abduct the arm. It is particularly
useful in the diagnosis of posterior shoulder dislocations.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand backward near the edge of the X ray couch.
10 x 8 Cassette placed near the edge of the X ray couch behind the patient.
Patient to bend backward 30° towards the table.
Cassette is adjusted so that glenoid cavity and head of the humerus are included.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through Glenohumeral joint.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
CLAVICLE X RAY
■ VIEWS
– AP, PA, INFERIOR TO SUPERIOR
CLAVICLE AP VIEW
AIM
To view the tumor progression or multiple cancers.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Supine position over the X ray Couch.
Affected side forearm and arm is extended and abducted.
12 x 10 Cassette placed under the clavicle including medial and lateral end of the clavicle.
Unaffected side is slightly raised so that affected side contact Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass between medial and lateral end of the clavicle.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
CLAVICLE PA VIEW
AIM
To view the tumor progression or multiple cancers.

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand in erect position near the Chest stand.
Affected side forearm and arm is extended and abducted.
12 x 10 Cassette placed on the chest stand upper border above shoulder and lower border below scapula.
Unaffected side is slightly raised so that affected side contact Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal so that central ray should pass through middle of the Scapula.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
CLAVICLE INFERIOR TO SUPERIOR VIEW
AIM
To view the delineate fracture displacement, fractures to the medial clavicle.

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying supine position over the X ray couch.
Affected side forearm and arm is extended and abducted.
12 x 10 Cassette placed under the clavicle with 20 ° angulation and the position is maintained by pillow.
Cassette is adjusted including medial and lateral end of clavicle.
Unaffected side is slightly raised so that affected side contact Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 45 ° Cranially ( towards head ) so that central ray should pass through middle of the
middle of the clavicle.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
ACROMIOCLAVICULAR JOINT AP VIEW
AIM
To examine the suspected Acromioclavicular joint injury.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand upright position near the Chest stand.
12 x 10 Cassette placed chest stand upper border above the shoulder lower border below Scapula.
Shoulder joint must make contact with the cassette.
Patient’s arm should be in neutral position.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through Acromioclavicular joint.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
ACROMIOCLAVICULAR JOINT STRESS VIEW
AIM
This view is used in the assessment of possible acromioclavicular joint separation and may be done bilaterally to
allow comparison of joint spaces between the affected and unaffected side.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand upright position near the Chest stand.
12 x 10 Cassette placed chest stand upper border above the shoulder lower border below Scapula.
Shoulder joint must make contact with the cassette.
Patient’s arm should be in neutral position.
Patient to hold 5 kg sandbag on the affected side.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through Acromioclavicular joint.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
ACROMIOCLAVICULAR JOINT AXIAL VIEW ( ZANCA VIEW )
AIM
To examine the suspected Acromioclavicular subluxation or dislocation.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient stand upright position near the Chest stand.
12 x 10 Cassette placed chest stand upper border above the shoulder lower border below Scapula.
Shoulder joint must make contact with the cassette.
Patient’s arm can be put down completely.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is horizontal and tilted 10 -15 ° Cranially ( towards head ) so that central ray should pass through Coracoid
Process.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
STERNOCLAVICULAR JOINT PA VIEW
AIM
To demonstrate sternoclavicular joint dislocation or medial end clavicular fractures
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying prone position over the X ray couch.
12 x 10 Cassette placed under the clavicle including medial end of the clavicle.
Cassette is adjusted so that sternoclavicular joint is in the middle of the Cassette
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through T3-T4.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
STERNOCLAVICULAR JOINT OBLIQUE VIEW
AIM
To demonstrate sternoclavicular joint dislocation or medial end clavicular fractures
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying prone position over the X ray couch.
12 x 10 Cassette placed under the clavicle including medial end of the clavicle.
Patient rotated towards unaffected side 10-15° and the position is maintained.
Cassette is adjusted so that sternoclavicular joint is in the middle of the Cassette
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through T3-T4
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
STERNOCLAVICULAR JOINT
SERENDIPITY VIEW OR ROCKWOOD VIEW
AIM
To demonstrate sternoclavicular joint dislocation or medial end clavicular fractures

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Supine position over the X ray couch.
12 x 10 Cassette placed under the clavicle including medial end of the clavicle.
Upper limbs are extended.
Cassette is adjusted so that sternoclavicular joint is in the middle of the Cassette
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical and tilted 40° Cranially ( towards head ) so that central ray should pass through T3-T4
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SCAPULA X RAYS
■ VIEW
AP, Y VIEW
SCAPULA AP VIEW
AIM
To diagnose and monitor the scapula fractures .

GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Supine position over the X ray Couch.
Affected side forearm and arm is extended and abducted.
10 x 8 Cassette placed under the scapula upper border above shoulder and lower border below scapula.
Unaffected side is slightly raised so that affected side contact Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through middle of scapula.
EXPOSURE FACTOR
KV = 60-65. MA = 100
MAS = 25-30. FFD = 90 CM Collimated
SCAPULA Y VIEW
AIM
To view the suspected Shoulder dislocations.
GENERAL INSTRUCTIONS
Patient to remove the radiopaque metals.
PATIENT POSITION
Patient lying Prone position over the X ray Couch.
Affected side arm is abducted and the elbow is flexed and dorsal surface of hand touches the back side of waist.
12 x 10 Cassette placed Bucky.
Cassette is adjusted upper border above shoulder and lower border below scapula.
Unaffected side is raised 45 °so that affected side contact Cassette.
Head is rotated towards the unaffected side.
Patient is immobilized.
CENTERING OF X RAY TUBE
Tube is vertical so that central ray should pass through middle of scapula.
EXPOSURE FACTOR
KV = 60-65. MA = 200
MAS = 50-60. FFD = 90 CM Collimated