At the intersection of the three limbs of the Y lies the glenoid fossa. The vertical portion of the Y is formed by the body of the scapula. 14 The upper arms of the Y are formed by the coracoid process anteriorly and by the scapular spine posteriorly. D, In posterior dislocations of the shoulder, the humeral head sits posterior to the glenoid fossa.Ī lateral projection of the scapula forms a Y shape (Fig. C, In anterior dislocations, the humeral head is displaced anterior to the glenoid fossa. Philadelphia: JB Lippincott, 1984.) B, A schematic drawing illustrates how the humeral head on the true scapulolateral radiograph should be centered around the glenoid fossa. (Modified from Rockwood CA, Green DP : Fractures, 2nd ed. Recommended radiographs for the trauma series include the following:įIGURE 5-7 A, How the line marked on the skin of the shoulder helps the technician visualize the plane of the x-ray for the true scapulolateral radiograph. The trauma series can also be used as baseline radiographs to evaluate many chronic shoulder problems as well. The radiographs used to evaluate traumatic shoulder problems have been referred to as the trauma series. McLaughlin, 1 Neer, 2, 3 Neviaser, 4 DeSmet, 5 Rockwood and Green, 6 Post, 7 Rowe, 8 Bateman, 9 and many others have recognized the shortcomings of the usual two anteroposterior radiographs of the shoulder and have recommended anteroposterior and lateral views to properly assess shoulder problems. Radiographs of the injured shoulder in two planes (anteroposterior and axillary lateral or scapular lateral) are absolutely essential to evaluation of an acutely injured shoulder. Modified axillary laterals or a computed tomography (CT) scan may be required.
The recommended views are the trauma series of radiographs, that is, true anteroposterior radiographs in internal and external rotation and an axillary lateral or a scapulolateral view.
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