Shoulder special views: Neer, West Point and Stryker notch

Neer outlet

The supraspinatus outlet view, the Neer method, is a scapular Y with an angle. Position the patient as for a PA oblique scapular Y, turned about 45 to 60 degrees with the affected side toward the IR, and the scapula on end. Angle the CR 10 to 15 degrees caudad and center to the humeral head. The angle opens the space under the acromion, the outlet the supraspinatus tendon passes through. It shows the shape of the acromion: type I flat, type II curved and type III hooked. A hooked acromion narrows the outlet and is linked with impingement and rotator cuff tears.