• Conditions affecting the scapula are comparatively rare, but when radiography is necessary, it is not an easy area to show effectively.
• If general anesthesia is not used, then heavy sedation with analgesia is needed, especially for the craniocaudal projection.
• A grid is necessary for patients with thickness >10 cm.
• The film must include the whole bone, must be correctly exposed and developed, and free from movement blur and artefact.
• The anatomical marker must be clearly visible.
  • If manual processing is used then the patient’s identification, the date, and the name of the hospital or practice must also be visible.

Uses

• Fracture.
• Neoplasia Bone: neoplasia.
• Infection.

Advantages

• Non-invasive.

Disadvantages

• Radiation exposure to patient/personnel.

Time required

Preparation

• Dependent upon the method of chemical restraint, (GA or sedation).

Procedure

• 10-15 min or longer, dependent upon skill of radiographer.

Decision taking

Criteria for choosing test

• Can you make the diagnosis without it?
• Can it tell you what you need to know?
• Will your management be affected by the radiological findings?

• At least two projections are necessary for a full assessment.

• For demonstrating the glenoid cavityof the scapula, this is the position of choice in conjunction with the caudocranial.

• Shows part of the body of the scapula.
• This projection is simple to position and brings the bone into a flat orientation parallel to the film.
• It has the disadvantage that a number of structures (most problematically some of the vertebrae), overlie the scapula making interpretation difficult.

• This successfully demonstrates the neck and body of the scapula, without the problem of overlying structures.
• While the obliquity causes some foreshortening, this view is likely to be of more overall use than the "through lung" lateral.
• It is also easy to position and can be reversed if it is too painful for the patient to lie on the affected side.

• Provides undistorted view.
• Easy to obtain.

• Provides a tangential view of scapular spine and body.
• Useful to characterize and detect subtle lesions such as green stick fractures.