UMEM Educational Pearls

Category: Orthopedics

Title: Evaluation of SLAP tears

Keywords: shoulder pain, labrum tear (PubMed Search)

Posted: 7/22/2023 by Brian Corwell, MD (Updated: 12/2/2023)
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SLAP tear/lesion – Superior labral tear oriented anterior to posterior

Glenoid labrum – A rim of fibrocartilaginous tissue surrounding the glenoid rim, deepening the “socket” joint.

Integral to shoulder stability.

https://aosm.in/storage/2019/05/ch-shoulder-slap.jpg

 

O’Brien’s test aka active compression test for superior labral pathology.

 

2 parts – generally performed with the patient standing.

 

The patient’s shoulder is raised to 90 degrees with full elbow extension and approximately 30 degrees of adduction across the midline.

Resistance is applied, using an isometric hold.

Test in both full internal and external rotation

         -This alters the position and rotation of the humerus against the glenoid

A positive test is when pain is elicited when the shoulder is in internal rotation with forearm pronation (thumb to floor) and much less or no pain when in external rotation (supination).

Note: AC joint pain may test similarly but will localize to different area of shoulder

The presence of similar, reproducible deep and diffuse glenohumeral joint pain is most indicative of a true positive test.

 

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