Scapula Projections

Patient Preparation

• Explain the procedure to the patient.
• Remove jewelry or metallic objects from the shoulder/upper chest area.
• Position the patient comfortably, standing, seated, or supine.
• Use lead shielding as appropriate.

BASIC PROJECTIONS

1. AP Projection — Scapula

Positioning:

• Patient standing, seated, or supine.
• Arm abducted 90° and flexed at elbow (hand supinated).
• Scapula flat against IR.

Central Ray (CR):

• Perpendicular to IR.
• Directed to mid-scapula (approximately 2 inches inferior to coracoid process).

SID:

• 100–110 cm (40–44 inches).

Collimation:

• Include entire scapula and lateral border of rib cage.

2. Lateral Projection — Scapula

Positioning:

• Patient rotated 45–60° toward affected side (oblique position).
• Arm positioned depending on part being visualized:
  • Acromion and Coracoid: Arm across chest.
  • Body of Scapula: Arm abducted 90°, elbow flexed.
• Scapula perpendicular to IR.

Central Ray (CR):

• Perpendicular to IR.
• Directed to mid-scapula.

SID:

• 100–110 cm (40–44 inches).

Collimation:

• Include entire scapula from acromion to inferior angle.

Common Pathologies Demonstrated

• Fractures of scapula, acromion, or coracoid.
• Dislocations of glenohumeral joint.
• Osteoarthritis or degenerative changes.
• Bone lesions or tumors.