The primary reason to make a shoulder x-ray is to confirm or exclude the presence of a fracture. Additionally, the image can provide information on the position of the shoulder joint, any bone abnormalities (including bone tumors) and soft tissue disorders (think of calcifications in the rotator cuff muscles).
Many hospitals have their own protocol for shoulder imaging.
A standard image normally includes an anteroposterior (AP) image . It can be made either in endorotation or in exorotation.