Abstract
The aim of the study was to determine the value of clinical assessment in the diagnosis of SLAP (Superior Labral Anterior Posterior) lesions of shoulder.
A retrospective clinical review of 48 patients who underwent arthroscopic stabilisation for SLAP (Snyder Type II to Type IV) lesions between 1997 and 2003 was undertaken. The patients were assessed preoperatively by the senior author using a combination of clinical tests including Neer’s impingement test, anterior apprehension test, compression rotation test, O’Brien, Speed, Gerber and Yergason tests.
The mean age of the patients was forty-four. Thirty-nine patients had persistent shoulder pain after injury. Seventeen were sport related. Pre operative diagnosis of SLAP was made in only eleven cases. We found the Neer impingement test positive in twenty-one, anterior apprehension test in twenty-six (sensitivity 54%), O’Brien test in twenty-three (sensitivity 48%), Compression rotation test in six and Speed’s test in five patients.
Our study does not support any single or combination clinical tests that can diagnose SLAP lesions with confidence. In a young patient with persisting shoulder pain after injury, positive anterior apprehension test should alert suspicion. Arthroscopic examination remains the most reliable assessment of the damaged labrum.
These abstracts were prepared by Mr Cormac Kelly. Correspondence should be addressed to him c/o British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
