Roentgenographic evaluation of suspected shoulder dislocation: a prospective study comparing the axillary view and the scapular 'Y' view.

Abstract

This study compares the axillary and the scapular "Y" view in 75 consecutive patients with suspected shoulder dislocation who were evaluated according to a prospective protocol. In each patient, an AP, axillary, and scapular "Y" view was obtained. Evaluation was by the following criteria: accuracy of diagnosis; patient preference; ease of technique; and diagnosis of associated pathology. In 69 cases (92%), the scapular "Y" view and axillary view resulted in the same diagnosis. However, in six cases (8%), the axillary view failed to give the correct diagnosis when compared to the scapular "Y" view. Sixty-one patients (81%) preferred the scapular "Y" view to the axillary view because of less pain. Once the technician was adept with the scapular "Y" view, it was preferred and was considered easier to obtain than the axillary view. With the exception of the Hill-Sachs lesion, the axillary view and scapular "Y" view visualized associated pathology equally well. A new method to obtain the scapular "Y" view is described. The technique is easy to use, and routinely results in an accurate diagnosis with minimal patient discomfort.