Standard Radiographic Views for 2-Week Post-Rotator Cuff Repair
For routine 2-week postoperative follow-up after rotator cuff repair, obtain a standard 3-view shoulder series: anteroposterior (AP) view with the humerus in neutral position, and an axillary lateral view OR scapular Y view. This follows the established trauma/shoulder imaging protocol that requires at least 3 views with 2 orthogonal projections 1.
Recommended Views
The standard postoperative radiographic series should include:
AP view (Grashey projection preferred): This profiles the glenohumeral joint by positioning the patient in a 30° posterior oblique, providing an AP view relative to the scapula rather than the body 2, 1, 2
Axillary lateral view OR Scapular Y view: These orthogonal views are essential for detecting malalignment, hardware position, and joint relationships that can be missed on AP views alone 1
Additional AP view: Can be obtained with internal or external rotation if needed to better visualize specific structures 2
Clinical Rationale
At 2 weeks postoperatively, radiographs serve to:
- Confirm appropriate hardware placement (anchors, sutures)
- Rule out fracture or hardware complications
- Assess joint alignment and spacing
- Establish baseline for comparison if symptoms develop later
The axillary or scapular Y view is particularly critical because glenohumeral malalignment and acromioclavicular pathology can be completely missed on AP views alone 1. While the axillary view may cause some discomfort in the early postoperative period, it can typically be obtained at 2 weeks with appropriate patient positioning and support.
Important Caveats
Upright imaging is preferred when possible, as supine radiographs can underrepresent shoulder malalignment 1
Soft tissue evaluation requires advanced imaging: If there is concern for repair integrity, retear, or other soft tissue complications, radiographs are insufficient. MRI or ultrasound would be needed, though interpretation can be challenging in the first 6 months due to heterogeneous healing appearance 3, 4, 5
Correlation with clinical findings is essential: Postoperative imaging abnormalities do not necessarily correlate with symptoms 3, 4
The 3-view series (AP/Grashey + axillary or Y-view + additional AP rotation view) represents the minimum standard for adequate postoperative shoulder imaging 2, 1.