The modified axillary view of the shoulder, a painless alternative

In our department, axillary views of the shoulder in trauma patients are not performed on a routine base, but sometimes, they are ordered by the trauma surgeon. We usually perform an anteroposterior view of the shoulder, combined with a posterior and an anterior oblique view of the shoulder in trauma patients. Because the classical described axillary view of the shoulder is sometimes very painful for the patient, especially in patients with humeral fractures, we perform a less painful modified axillary view.

We now perform the axillary view with the patient standing upright and bending forward and we give a craniocaudal tube inclination between 30 and 45 degrees. Doing so, we also have an "axillary" view on the shoulder, but without harm for the patient. We performed a retrospective study in 103 patients with a modified axillary view and the additional value was checked.

We conclude that the modified axillary view is useful in 30 patients for detection of Hill-Sachs lesions or evaluation for displacement or angulation in proximal humeral fractures.