How to Read Shoulder X-rays Like an Orthopedic Surgeon

Learn how to read shoulder X-rays using the same systematic approach used in orthopedic practice. This video walks healthcare providers through shoulder X-ray interpretation step by step, including normal anatomy, essential radiographic views, common fractures, shoulder dislocations, AC joint injuries, arthritis, rotator cuff pathology, and other important findings. Whether you’re a physician, PA, NP, medical student, resident, or other healthcare professional working in orthopedics, emergency medicine, urgent care, sports medicine, or primary care, this video will help you develop a more consistent approach to interpreting shoulder radiographs—and avoid missing subtle but important abnormalities. In this video, we apply the A–H method of X-ray interpretation specifically to the shoulder: A — Alignment Evaluate the glenohumeral and acromioclavicular joints for dislocation, subluxation, AC separation, superior migration of the humeral head, and other abnormalities of alignment. B — Bones Systematically inspect the proximal humerus, clavicle, acromion, coracoid, glenoid, and scapula for fractures and other osseous abnormalities. Learn to recognize findings such as Hill-Sachs lesions, bony Bankart lesions, and os acromiale. C — Cartilage & Calcification Look for joint-space narrowing, osteophytes, subchondral sclerosis, glenohumeral and AC joint osteoarthritis, and calcific tendinitis. D — Density Identify abnormal areas of sclerosis or lucency that may indicate chronic rotator cuff disease, distal clavicle osteolysis, cystic changes, bone lesions, osteoporosis, or avascular necrosis. E — Effusion & Soft Tissue Recognize soft-tissue abnormalities and consider the significance of a shoulder joint effusion in the setting of trauma, inflammation, or infection. F — Foreign Bodies Look for radiopaque foreign bodies, loose bodies, and complications involving orthopedic hardware. G — Gas Recognize abnormal soft-tissue gas associated with penetrating trauma or infection. H — Harmonize Bring the X-ray findings together with the patient’s history and physical examination. Radiographs should never be interpreted in isolation. We also review the major shoulder X-ray views and explain what each one is designed to show, including: • AP shoulder view • Grashey (true AP) view • Internal and external rotation views • Scapular Y view • Axillary view • Velpeau view • Trauma shoulder series The goal isn’t simply to spot an obvious fracture. It’s to develop a repeatable system that helps you recognize subtle abnormalities, distinguish normal variants from pathology, and know when the X-rays don’t adequately explain the patient’s symptoms. If you work in orthopedics, emergency medicine, urgent care, sports medicine, or primary care, subscribe for more practical videos on musculoskeletal diagnosis, X-ray interpretation, fractures, orthopedic examination, and treatment. 👍 If you found the video useful, please like the video. 💬 Have another shoulder X-ray finding clinicians should know? Add it in the comments. 🔔 Subscribe for upcoming videos covering other orthopedic X-ray series. #ShoulderXray #XrayInterpretation #Orthopedics #Radiology #EmergencyMedicine #SportsMedicine #UrgentCare #MedicalEducation