Reading Clavicle X-rays
Displacement, shortening, and the joints at both ends.
Aug 31, 2026 · 3 refs
At a glance
Clavicle films must show the AC joint, the shaft, and the sternoclavicular region. Shortening and displacement are why people operate; a cropped midshaft view that misses the AC joint is a missed injury.
Technique pointers
Series
- AP of the clavicle including AC and SC regions
- 15–30° cephalic tilt when the shaft is superimposed on the ribs
- Zanca view if the AC joint is the question
Describe
- Thirds (proximal / mid / distal)
- Shortening and superior displacement of the medial fragment
- Skin tenting on the exam, not the film
Decision-making
Comminuted, shortened midshaft fractures and distal (Neer) patterns with CC ligament incompetence change counseling. Open or tented skin is an operative conversation tonight, not a clinic deferral.
High-yield / exam
- Include both joints
- Shortening and displacement drive the discussion
- Distal-third patterns are not “just a clavicle”
- Skin tenting is a clinical finding you still have to look for
Questions
Ortho Skills (Real Life) and Boards items for this topic are coming.
Your pearl
One line you’d tell a junior at 2am.
References
- 01
Clavicle fractures — evaluation and treatment
2013 · Journal of the American Academy of Orthopaedic Surgeons · review
Displacement and shortening on adequate films frame non-op vs surgery.
- 02
AAOS clavicle fracture guideline themes
2014 · American Academy of Orthopaedic Surgeons (guidelines / AUC) · guideline
Shared decision-making starts with a complete radiograph.
- 03
OTA teaching on clavicle radiographic evaluation
2018 · Orthopaedic Trauma Association · guideline
Do not crop out the AC or SC joints.
From the Journal
Films and cases live in the long-form. This Topic is the system.
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