Educational Resources for Shoulder Radiographic Views
Yes, you can obtain educational images of shoulder radiographs including AP internal-rotation, AP external-rotation, axillary/scapular-Y, Stryker notch, and Bernageau views through multiple established sources, as these are standard imaging projections recommended by current guidelines for evaluating shoulder pathology.
Standard Shoulder Radiographic Series
According to the most recent ACR Appropriateness Criteria (2025), the standard trauma shoulder radiographic series should include at minimum 1:
- AP views in internal rotation - Essential for visualizing Hill-Sachs lesions and humeral head pathology
- AP views in external rotation - Provides complementary assessment of bony anatomy
- Axillary or scapular-Y view - Critical for detecting glenohumeral and acromioclavicular joint dislocations that can be missed on AP views alone
Specialized Views for Learning
Stryker Notch View
The Stryker notch view is specifically designed to evaluate Hill-Sachs lesions 1. This specialized projection provides superior visualization of posterolateral humeral head defects that may be subtle or missed on standard AP views 2.
Bernageau View
The Bernageau view is highly effective for demonstrating glenoid bone loss 3. Recent research validates this view as an accurate and reproducible technique for measuring glenoid erosion, with results comparable to 3D CT scanning 4. The view allows calculation of the percentage of anterior glenoid bone loss by measuring the distance between posterior and anterior glenoid rims 5.
Sources for Educational Images
Recommended resources for obtaining these images include:
- ACR Appropriateness Criteria documents - Provide standardized imaging protocols and often include example images
- Radiology teaching files from academic medical centers
- Orthopedic and radiology textbooks focusing on musculoskeletal imaging
- Professional society websites (American College of Radiology, Radiological Society of North America)
- Peer-reviewed journal articles on shoulder imaging techniques 6
Clinical Context for Each View
Understanding when each view is indicated enhances learning value:
- AP internal/external rotation: Initial evaluation of all shoulder trauma and pain 1
- Axillary/Scapular-Y: Mandatory for ruling out dislocation, as dislocations can be misclassified on AP views alone 3
- Stryker notch: Targeted evaluation when Hill-Sachs lesion is suspected but not visible on standard views 1
- Bernageau: Assessment of glenoid bone loss in recurrent instability, particularly useful for surgical planning 5, 4
Important Technical Considerations
Positioning accuracy is critical - The scapular Y view requires specific technique to achieve proper superimposition of the glenoid, and many technologists struggle with this projection 7, 8. When learning from images, pay attention to proper patient positioning and beam angulation to understand what constitutes a diagnostic-quality study versus a suboptimal one.
Upright positioning is preferred over supine radiography when possible, as shoulder malalignment can be underrepresented on supine images 3.