SLAP Lesion

Aka: SLAP Lesion, Superior Labrum Anterior to Posterior Tear, Shoulder Labral Tear, Glenoid Labrum Tear

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II. Pathophysiology

  1. Superior Labrum Anterior to Posterior Tear (SLAP Lesions)
    1. Associated with Biceps Tenosynovitis
    2. Superior labrum is more weakly attached to glenoid than inferior labrum
  2. Posterosuperior labral tears
    1. Less common than SLAP Lesions
    2. Secondary to fraying related to Internal Shoulder Impingement

III. Mechanism

  1. Direct blow to Shoulder
  2. Fall on an outstretched hand
  3. Repetitive, high velocity overhead motion (e.g. throwing)
    1. SLAP Lesions are the most common labral injury in overhead throwing

IV. Symptoms

  1. Locking, catching or popping Sensation felt in the Shoulder

V. Signs

  1. Most reliable tests for labral tear
    1. Jobe Relocation Test (Shoulder Apprehension Test)
    2. O'Brien Test
    3. Anterior Slide Test
  2. Bicipital Tendonitis tests (associated with SLAP Lesions)
    1. Speed Test
    2. Yergason Test

VI. Imaging: MR Arthrography of the Shoulder

  1. Anterior labral tears in adults
    1. Test Sensitivity: 95%
    2. Test Specificity: 100%
  2. Superior labral tears
    1. Test Sensitivity: 60%
  3. Posterior labral tears
    1. Test Sensitivity: 50%

VII. References

  1. Edmonds (2014) Am Fam Physician 89(7): 537-41 [PubMed]

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