Usually, an X-ray image shows the consequences of a violation - for example, an injury. These can be chips, complete or partial fractures. You can also see signs of an inflammatory reaction, the presence of seals, birth defects (in particular, a change in the configuration and size of the scapula). 
A fracture of the scapula on x-ray is determined by a change in bone color and the presence of a clear line of darkening. With such damage, it is important to identify the type of fracture:
- fracture of the scapular neck;
- body and angles of the scapula;
- scapular articular process;
- scapular spine;
- coracoid and acromial scapular process.
Fractures of the scapula are relatively rare, in about 1–2% of all bone fractures. They can appear after falling on the back, due to direct impact. More often, there is a transverse fracture of the body of the scapula on x-ray, in the area below the spine, somewhat less often - a fracture of the neck and processes. In isolated cases, longitudinal damage to the body of the bone is found, which are accompanied by a strong separation of the fragments. 
By examining a fracture of the scapula neck on x-ray, the radiologist can distinguish between single or multiple splinters. A multi-splinter fracture is referred to if one or more completely separated intermediate bone fragments are present.
The suprahumeral and beak-shaped processes often break off with direct impacts to the scapula, when falling on the back from a great height, or with an emphasis on the upper limb. A fracture of the coracoid process of the scapula on x-ray can be combined with injuries to the ribs.
X-ray anatomy of the scapula
When decoding an X-ray image by traumatologists and orthopedists, it is very important to know the anatomical features and the ability to spatially construct anatomical elements with the designation of changes in their relationship with each other, which is expressed in degrees and millimeters.
The scapula is a kind of triangle adjacent to the posterior surface of the chest in the space from the second to the seventh rib. Taking into account the shape of the bone, three edges are distinguished in it:
- medial edge ("looks" at the spine);
- lateral edge;
- the upper edge, on which the scapular notch is localized.
The specified edges are joined at specific angles. One of these angles - the lower - is directed downward, and the upper and lateral are located at the ends of the upper scapular edge. The lateral angle is thicker than the others and has a slightly deepened glenoid cavity. The edge of the cavity is separated from the rest of the scapula by a neck.
Above the upper border of the depression there is an elevation, a tubercle, to which the tendon of the long head of the biceps muscles is attached. The lower border also has a similar elevation with attachment of the long head of the triceps brachialis muscle. The coracoid process is retracted from the upper border of the scapula near the glenoid cavity. 
The anterior, or costal scapular surface is a flattened depression called the subscapular fossa. The spine of the scapula runs along the posterior plane, dividing this surface into two depressions: the supraspinatus and infraspinatus fossa. 
The scapula from the posterior projection is a triangular formation with three edges, corners and processes. At the base of the coracoid process, you can consider the notch: inexperienced specialists can take it for a zone of bone destruction, which is especially common during the diagnosis of elderly patients with signs of senile calcification, when the notch transforms into a hole.