Radiographer Preferences for Shoulder x-Ray Imaging in Australia: A National Survey

Shoulder pathology is common, with many people referred for general radiography examinations. In performing these examinations, radiographers have a choice of more than 15 views to demonstrate the anatomy and pathology. The lack of guidelines for the best combination of orthogonal views in specific scenarios raises concerns for effectiveness, efficiency, and radiation safety. The aim of this study was to gain an understanding of the current practice by radiographers across Australia.

A national, cross-sectional online survey obtained data on the views and combination of views, (protocols) preferred by Australian radiographers across five common pathological presentations. The data were analysed descriptively.

Data from 164 radiographers found a wide variation in shoulder imaging preferences; however, some common shoulder imaging protocols were identified for shoulder trauma presentations. The most variation and highest number of imaging protocols selected were for shoulder arthritis and impingement. Trauma and glenohumeral dislocation had the least variation and number of views selected. The three most common views across all pathologies were lateral Y scapula, anteroposterior general survey (neutral rotation), and true anteroposterior/Grashey (internal rotation). Radiographers working in private settings selected more views than those in public settings.

This study demonstrates a wide variation in image preferences of Australian radiographers performing shoulder imaging. However, some common shoulder imaging protocols were identified for shoulder trauma presentations. Greater standardisation of shoulder imaging protocols may reduce unnecessary patient risk and improve the patient experience.