What X-ray (X-ray) view is used to rule out dislocation?

X-ray Views to Rule Out Joint Dislocation

The axillary lateral view or scapular Y view is essential for ruling out shoulder dislocation, while standard anteroposterior (AP) and lateral views are necessary for other joints. 1

Shoulder Dislocation Imaging

Primary Views

• Anteroposterior (AP) views in internal and external rotation
• Axillary lateral view or scapular Y view (critical for dislocation assessment)

The axillary or scapular Y views are vital because:

• Acromioclavicular and glenohumeral dislocations can be misclassified on AP views alone 1
• These orthogonal views allow visualization of the relationship between the humeral head and glenoid 1

Important Considerations

• A standard shoulder trauma protocol should include at least three views 1
• Radiography should be performed upright when possible, as malalignment can be underrepresented on supine radiography 1
• The position required for axillary lateral view may be painful for patients who have just dislocated their shoulders 1
• Care should be taken if the shoulder has just been reduced because positioning may lead to redislocation 1

Knee Dislocation Imaging

Primary Views

• Anteroposterior (AP) view
• Lateral view
• Patellofemoral view (for suspected patellar fractures/subluxation/dislocation) 1

For knee trauma, radiographs should be the initial imaging modality when Ottawa rule criteria are positive 1.

Other Joints

Hip Dislocation

• AP radiographs of the pelvis will show dislocation in most patients
• Lateral views or CT scan may be required to confirm the diagnosis and direction if signs are subtle 2

Hallux Interphalangeal Joint

• Lateral and oblique views are essential after attempted reduction to confirm proper alignment 3
• Post-reduction imaging is critical as some dislocations may appear reduced but remain subluxed

Post-Reduction Imaging

Post-reduction radiographs are important to:

• Confirm successful reduction
• Identify fractures not visible on pre-reduction films (up to 37.5% of fractures may only be visible after reduction) 4
• Detect residual subluxation

Common Pitfalls

1. Inadequate views: Relying solely on AP views can lead to missed dislocations, particularly in the shoulder 1
2. Poor positioning: Improper patient positioning can affect visualization of joint alignment 1
3. Failure to obtain post-reduction imaging: Some fractures are only visible after reduction 4
4. Pain limiting proper positioning: Especially for axillary views in acute shoulder dislocations 1

For optimal assessment of joint alignment and to rule out dislocation, orthogonal views (views at 90° to each other) are essential to visualize the three-dimensional relationship between joint components.