Shoulder

SLAP Lesion

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SLAP Lesion, Superior Labrum Anterior to Posterior Tear, Labral Tear, Glenoid Labrum Tear

  • 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
  • Pathophysiology
  • Mechanism of Injury
  1. Direct blow to Shoulder
  2. Fall on an outstretched hand
  3. Repetitive overhead motion
    1. SLAP Lesions are the most common labral injury in overhead throwing
  • Symptoms
  1. Locking, catching or popping sensation felt in the Shoulder
  • 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
  • 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%