Private Shoulder X-Ray

A shoulder X-ray uses a small dose of ionising radiation to take pictures of the bones that make up the shoulder: the top of the upper arm bone, the shoulder blade and the collarbone. The NHS says a health professional assessing your shoulder pain will examine you and might send you for tests, such as an X-ray, to check the cause.

Many shoulder problems involve tendons and other soft tissues, which an X-ray is not designed to look at in detail, so ultrasound or MRI is sometimes the more useful test. This page explains what a shoulder X-ray is used for, when the NHS suggests trying self-care or seeing a GP first, the referral rules for X-rays in the UK, and how to compare clinics and send an enquiry through FindScan. FindScan is a directory and enquiry service. We do not carry out scans or give medical advice.

What a shoulder X-ray shows

A standard X-ray is mainly used to look at bones. On a shoulder X-ray, the clinician can look at the bones of the joint, how they line up with each other and the space between them. Depending on the question your referrer is asking, more than one view is often taken.

Tendons, muscles and ligaments, including the rotator cuff, are not shown in detail on a standard X-ray. When those are the main concern, your clinician may suggest an ultrasound scan or a shoulder MRI scan instead. Neither uses ionising radiation.

Common reasons for a shoulder X-ray

The NHS lists many possible causes of shoulder pain, including frozen shoulder, osteoarthritis, rheumatoid arthritis, tendonitis, bursitis, shoulder impingement, shoulder instability, a dislocated shoulder, broken bones and ruptured tendons. Imaging is relevant to some of these more than others.

• Arthritis. The NHS links long-lasting shoulder pain and stiffness with osteoarthritis and rheumatoid arthritis, as well as frozen shoulder. For osteoarthritis in general, the NHS says X-rays are not usually needed for diagnosis but may be used to rule out other causes.
• Calcific tendinopathy. This is caused by calcium building up in the rotator cuff tendons. NHS guidance from Bristol, North Somerset and South Gloucestershire says that, after an assessment, imaging tests may be ordered, and these may include X-rays or ultrasound scans of the shoulder.
• Dislocation and fracture. The NHS says you will usually have an X-ray to check a shoulder is dislocated. This happens through A&E, not a private clinic (see below).
• Frozen shoulder. The NHS describes pain that can be worse at night and stiffness that makes the shoulder hard to move. Its guidance focuses on pain relief and restoring movement through exercises or physiotherapy, rather than on scans.

When to see a GP, call 111 or go to A&E

Shoulder pain often starts with self-care rather than a scan. The NHS recommends staying active, gentle movement and pain relief, and says you usually need to do these things for 2 weeks before shoulder pain starts to ease. It can take 6 months or longer to recover. See a GP if your shoulder pain is getting worse or does not improve after 2 weeks, or if it is very difficult to move your arm or shoulder. The NHS also says that in many areas you may be able to get help, such as physiotherapy, from NHS community musculoskeletal (MSK) services without needing a referral from a GP.

Ask for an urgent GP appointment or get help from NHS 111 if:

• you have sudden or very bad shoulder pain
• you cannot move your arm
• your arm or shoulder has changed shape or is badly swollen
• you have pins and needles that do not go away, or there is no feeling in your arm or shoulder
• your arm or shoulder is hot or cold to touch
• the pain started after an injury or accident, like a fall
• you develop severe pain in both shoulders, or feel feverish or unwell

Go to A&E if you have injured your shoulder and think it may be dislocated, for example you cannot move your arm or your shoulder looks out of place. The NHS says to call 999 for an ambulance if you cannot get to A&E by yourself, and not to drive yourself.

X-ray, ultrasound or MRI?

The right test depends on the question being asked, and that is for your referrer to decide. As a broad guide, an X-ray is used to look at bone, while ultrasound or MRI is generally used when tendons or other soft tissues are the main concern. Read more in our guide to what a shoulder MRI shows.

Referral rules differ by test. Because MRI and ultrasound do not use ionising radiation, IR(ME)R does not apply to them. Many private clinics accept self-referral for these scans, usually after their own safety screening, but each clinic sets its own policy.

Do you need a referral for a private shoulder X-ray?

Yes. An X-ray uses ionising radiation, so it is covered by the Ionising Radiation (Medical Exposure) Regulations 2017 (IR(ME)R). Every exposure must be requested by a referrer and justified by a practitioner as showing a sufficient net benefit before it goes ahead.

Private clinics often arrange this through their own doctor or a clinical review of your symptoms, and each clinic sets its own process. Ask about it when you enquire. Our guide to how referrals for private X-rays work explains more.

Preparing for your shoulder X-ray and what happens

The NHS says you may be asked not to wear anything that has metal in it, such as jewellery, bras, clothes with zips or poppers, or hair clips. For a shoulder X-ray you may be asked to change into a gown. Tell the staff beforehand if you are or might be pregnant, are breastfeeding, or have any allergies.

A radiographer positions your shoulder and the machine, then asks you to keep very still for a few seconds while one or more pictures are taken. Staff usually step out of the room briefly during each exposure. The X-ray itself typically takes a few minutes.

Results, radiation dose and safety

Your images will be reported by an appropriately qualified clinician. The clinic will tell you how long its report takes and who it will be sent to. Make sure someone, such as the referring doctor, your GP or physiotherapist, can explain what it means for your treatment.

UKHSA patient dose guidance gives a typical effective dose of less than 0.01 mSv for X-rays of the limbs and joints other than the hip, which it compares to less than 1.5 days of natural background radiation. The NHS says serious complications from X-rays are rare, but that having lots of X-rays carries a very small risk that the radiation could cause cancer. See our X-ray radiation safety guide.

What affects the price, and how to compare clinics

Prices vary by clinic. The number of views, whether one or both shoulders are imaged, how the clinic handles the referral, how the report is provided and the clinic's location can all make a difference. FindScan shows each clinic's own listed price, as set by the clinic, without mark-up. Our guide to private X-ray costs explains more.

Compare X-ray clinics near you, check what each says about referrals and reporting, then send an enquiry to the one you choose. FindScan passes your details to that clinic, and the clinic contacts you directly to arrange the referral, appointment and payment. FindScan does not take bookings or payments.