A standard set of shoulder radiographs for trauma should include at least three views: anterior-posterior (AP) views in internal and external rotation and an axillary or scapula-Y view. Axillary or scapula-Y views are vital in evaluating traumatic shoulder injuries as acromioclavicular and glenohumeral dislocations can be misclassified on AP views [6,7]. Radiographs provide good delineation of bony anatomy to assess for fracture and appropriate shoulder alignment, which are the two primary concerns in management of acute traumatic shoulder pain. Radiographs should also be performed upright since malalignment of the shoulder can be under-represented on supine radiographs [4]. Additional views, such as the Bernageau view, have been shown to be effective in demonstrating the degree of bone loss of the glenoid or humeral head [8]. CT Shoulder Computed tomography (CT) is better able than radiographs to characterize fracture patterns [9-11]. However, radiographs are preferred over CT for initial evaluation because radiographs are able to diagnose displaced The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org fractures and shoulder malalignment, which are the primary concerns in the initial assessment of shoulder trauma. CT is considered inferior to MRI for diagnosing essentially all soft-tissue shoulder injuries. CT Arthrography Shoulder CT arthrogram, although not the initial study of choice, has the advantage of characterizing both bony lesions and significant soft-tissue injuries.
Shoulder Pain Traumatic PCAs. A standard set of shoulder radiographs for trauma should include at least three views: anterior-posterior (AP) views in internal and external rotation and an axillary or scapula-Y view. Axillary or scapula-Y views are vital in evaluating traumatic shoulder injuries as acromioclavicular and glenohumeral dislocations can be misclassified on AP views [6,7]. Radiographs provide good delineation of bony anatomy to assess for fracture and appropriate shoulder alignment, which are the two primary concerns in management of acute traumatic shoulder pain. Radiographs should also be performed upright since malalignment of the shoulder can be under-represented on supine radiographs [4]. Additional views, such as the Bernageau view, have been shown to be effective in demonstrating the degree of bone loss of the glenoid or humeral head [8]. CT Shoulder Computed tomography (CT) is better able than radiographs to characterize fracture patterns [9-11]. However, radiographs are preferred over CT for initial evaluation because radiographs are able to diagnose displaced The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. Reprint requests to: publications@acr.org fractures and shoulder malalignment, which are the primary concerns in the initial assessment of shoulder trauma. CT is considered inferior to MRI for diagnosing essentially all soft-tissue shoulder injuries. CT Arthrography Shoulder CT arthrogram, although not the initial study of choice, has the advantage of characterizing both bony lesions and significant soft-tissue injuries.