The Shoulder

Shoulder on X-Ray

Patients are commonly shown their own imaging studies during medical office visits. However, it’s difficult to interpret these images without context for what is “normal.” Here, we describe the features of a healthy shoulder, and showcase some prototypical features of shoulder pathology. Note that X-Rays reveal the bony anatomy of the shoulder and do not directly show soft tissue structures, such as the rotator cuff and labrum.

Normal Shoulder X-Rays

Here is an XR of the right shoulder from the front, called an “AP view.” Three features suggest that the XR looks “normal.”

  1. The humeral head is centered on the glenoid. In cases of chronic rotator cuff injuries, the humeral head may be positioned superiorly relative to the glenoid.

  2. There is space between the humeral head and the glenoid (arrows).

  3. The humeral head is round and does not have a bone spur.

Best Shoulder Surgeon Long Island New York

Here is an XR of the right shoulder taken from above, looking down at the shoulder, called an “axillary view.” On this view, a “normal” XR will exhibit space between the humerus and glenoid (arrow).

Best Shoulder Surgeon Long Island New York

Shoulder Pathology on X-Ray

Shoulder Osteoarthritis: The severity of arthritis can be estimated by 1) the level of space between the humeral head and glenoid and 2) the presence and size of a bone spur (osteophyte) on the humeral head.

Best Shoulder Surgeon Long Island New York
Best Shoulder Surgeon New York

Rotator Cuff Arthropathy: X-rays cannot determine directly if a patient has a rotator cuff tear, however we can infer the presence of long-standing rotator cuff insufficiency when the humeral head exhibits superior migration, relative to the glenoid.

Best Shoulder Surgeon Long Island New York

Acromioclavicular (AC) Joint Injury: The AC joint is inspected to ensure that the acromion (shoulder blade) aligns with the lateral end of the clavicle (collarbone). In an AC joint “separation” the lateral aspect of the clavicle displaces superiorly relative to the acromion.

Best Shoulder Surgeon Long Island New York

Disclaimer: The information provided on this website is intended for informational and educational purposes only. The opinions, views, and content presented here should not be construed as medical advice, diagnosis, or treatment. We welcome you to schedule a consultation with Dr. Brusalis for evaluation of your specific medical condition.