Clavicle AP Axial is a radiography positioning projection of the Upper Extremity. Erect, CR 15-30 degrees cephalad. Clavicle clear of ribs. SID 40". The centering point is located midshaft of the clavicle, with cr angled cephalad to clear the clavicle from ribs.. The central ray is angled 15-30 degrees cephalad to project the clavicle free of the thorax.. Image-quality criteria include entire clavicle from sternal end to acromion visualized., clavicle projected clear of thorax, ribs, and lung tissue.. Standard exposure ranges from 65 to 75 kVp, 5 to 10 mAs, at an SID of 40 inches (102 cm).
Anatomy demonstrated
- Entire clavicle free of thoracic superimposition.
- Sternal end of clavicle.
- Midshaft of clavicle.
- Acromial end of clavicle.
- Sternoclavicular joint.
- Acromioclavicular joint.
Patient preparation
- Verify patient identity using two identifiers.
- Remove watches, bracelets, and radiopaque items from chest.
- Position patient erect facing the IR.
- Keep arms at sides in a relaxed position.
- Straighten spine and keep shoulders level.
Position & centering point
Midshaft of the clavicle, with CR angled cephalad to clear the clavicle from ribs.
Central ray
Angled 15-30 degrees cephalad to project the clavicle free of the thorax.
Exposure / technique
- kVp
- 65–75
- mAs
- 5–10
- SID
- 40" (102 cm)
- Notes
- Erect technique. CR angled 15-30 degrees cephalad. Breathing: suspended at end of expiration.
Image-quality criteria
- Entire clavicle from sternal end to acromion visualized.
- Clavicle projected clear of thorax, ribs, and lung tissue.
- No superimposition with vertebral column or thorax.
- Medial and lateral clavicle sharp and well-defined.
- Sternal and acromion ends visible without foreshortening.
- Collimation: 1 inch above and 13 inches below the clavicle.
Common errors / ARRT traps
- 1 Insufficient cephalad angle leaves clavicle superimposed on ribs.
- 2 Excessive cephalad angle foreshortens the clavicle.
- 3 Patient shoulder elevation tilts and rotates the clavicle.
- 4 Forward shoulder position obscures the medial clavicle.
- 5 Off-centered CR misses the sternal or acromion end.
Clinical indications
- Clavicular fracture with complex displacement patterns.
- Midshaft clavicle fracture with superimposition on AP.
- Distal clavicle fracture or separation evaluation.
- Calcification or osteolysis assessment requiring clear visualization.
Aligned to the 2025 ARRT Content Specifications.