Perbandingan Informasi Anatomi Shoulder Joint Proyeksi Supraspinatus Outlet Metode Neer Dengan Arah Sinar 10° Dan 15° Caudad

Shoulder impingement syndrome is one of the major causes of shoulder pain that requires radiographic examination to evaluate the subacromial space. The supraspinatus outlet projection using the Neer method is commonly used to demonstrate this space; however, variations in the central ray direction may affect the quality of the anatomical information obtained. This study aimed to determine the differences in anatomical information of the shoulder joint on the supraspinatus outlet projection using the Neer method with 10° and 15° caudad central ray directions. This study employed a quantitative experimental approach using a within-subject comparison design. The sample consisted of six volunteers, each of whom underwent two radiographic examinations using 10° and 15° caudad central ray directions, resulting in 12 radiographic images. The images were evaluated by three radiologists based on five anatomical components: the glenohumeral joint, acromioclavicular joint, supraspinatus outlet area, superimposition of the humeral head, and posterior process of the acromion. The data were analyzed descriptively by comparing the anatomical information scores obtained using the 10° and 15° caudad central ray directions. The results showed that all samples demonstrated an increase in anatomical information scores when using the 15° caudad central ray direction, with a mean total score of 131.56 compared with 120.28 for the 10° caudad direction. The greatest increase was observed in the posterior process of the acromion component, with a mean difference of 3.33 points. Based on these findings, the 15° caudad central ray direction provided more optimal anatomical visualization than the 10° caudad direction in the supraspinatus outlet projection using the Neer method and may therefore improve the quality of diagnostic information in the evaluation of shoulder impingement syndrome.