X Ray Both Shoulder Axillary View

The axillary view is an X‑ray projection taken through the armpit with the beam directed upward through the glenohumeral joint. It shows the relationship of the humeral head to the glenoid, aiding detection of anterior or posterior dislocations, glenoid rim fractures and subtle proximal humeral fractures. It requires arm abduction (or a modified Velpeau/axillary technique if abduction is painful) and complements AP images.

The three standard shoulder X‑ray views are: 1) Anteroposterior (AP) — frontal view of the glenohumeral joint and clavicle; 2) Axillary — an inferior-to-superior view showing the glenohumeral relationship and detecting dislocations; 3) Scapular Y (lateral scapular) — oblique lateral view of the scapula, acromion and coracoid to assess fractures and dislocation.

The axial (axillary) shoulder view is an imaging projection with the beam directed through the axilla across the transverse plane. The patient sits or lies with the arm abducted about 90° (or a modified position if painful). It visualizes the glenohumeral joint, humeral head, glenoid rim and coracoid, and is especially useful for identifying anterior/posterior dislocations and glenoid or humeral head fractures.

An axial shoulder radiograph can be painful because it usually needs arm abduction and rotation, which is difficult after trauma, dislocation, or fracture. If the standard position is intolerable, technologists use modified techniques (e.g., Velpeau/trauma axial) or alternative views (scapular Y) and may opt for CT or MRI to avoid causing pain while still obtaining diagnostic images.

The usual shoulder X-ray series includes anteroposterior (AP) views — often both internal and external rotation — plus an axillary view and a scapular Y (lateral) view. AP views assess bones and joint space; axillary or transthoracic views detect dislocations and glenoid involvement; the scapular Y evaluates fracture alignment. Specialized views (Grashey/glenoid profile or Stryker notch) are used when needed.

The axillary area, commonly called the armpit, is the hollow between the upper arm and chest beneath the shoulder. It’s bounded by muscles (pectoralis major, latissimus dorsi, serratus anterior) and contains axillary lymph nodes, the axillary artery and vein, and branches of the brachial plexus. It’s clinically important for lymph node assessment, vascular access, and nerve-related symptoms.