The Evaluation of Various Physical Examinations for the Diagnosis of Type II Superior Labrum Anterior and Posterior Lesion

Oh, Joo Han; Kim, Jae Yoon; Kim, Woo Sung; Gong, Hyun Sik; Lee, Ji Ho

doi:10.1177/0363546507308363

Cited by 60 publications

(54 citation statements)

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“…33,41,44,47,50 One study used 3 physical examination tests: the compression rotation test, the anterior slide test, and the active compression test. 44 The accuracy of diagnosing SLAP tears was no higher with the use of all 3 tests in a given patient than with any one test or any combination of 2 tests.…”

Section: Multiple Physical Examination Tests For Superior Labrum Antementioning

confidence: 99%

Examination of the Biceps Tendon

McFarland

Borade

2016

Clinics in Sports Medicine

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Section: Multiple Physical Examination Tests For Superior Labrum Antementioning

confidence: 99%

Examination of the Biceps Tendon

McFarland

Borade

2016

Clinics in Sports Medicine

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“…All patients had positive results of a physical examination specific for SLAP lesion. 12) They also underwent preoperative computed tomography (CT) arthrography to detect leakage of contrast media through the biceps anchor with detachment from the bony glenoid. Of the patients who had a SLAP lesion on CT arthrography, those with failed conservative treatment for a minimum of 6 months elected to proceed with surgery.…”

Section: Patient Selectionmentioning

confidence: 99%

Age-related Outcome of Arthroscopic Repair of Isolated Type II Superior Labral Anterior to Posterior Lesions

Kwon

Kim

Yeom³

et al. 2015

Clinics in Shoulder and Elbow

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Background: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. Methods: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged ≥40 years. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. Results: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. Conclusions:The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered. (Clin Shoulder Elbow 2015;18(1):36-42)

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“…Researchers [3][4][5][6][7][8][9][10][11][12] investigating the diagnostic accuracy of these 3 tests for SLAP lesions have reported widely variable findings. Contributing to this variability are study design, particularly retrospective studies that can have low internal validity; verification bias when the criterion standard was applied only to patients who were positive on the investigated test; performance and positive criteria of the physical examination test; and severity of disease.…”

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confidence: 99%

“…In addition, the variability in diagnostic accuracy can be attributed to the use of different reference standard criteria across studies. The reference standard for SLAP lesions has included all SLAP lesions without differentiation among types, [3][4][5]8,11 only type I or II SLAP lesions, 6 only type II SLAP lesions, 10,12 and type II to IV SLAP lesions. 7,9 In 4 studies, researchers specifically excluded type I SLAP lesions because they did not consider these lesions a likely source of mechanical symptoms.…”

mentioning

confidence: 99%

“…7,9 In 4 studies, researchers specifically excluded type I SLAP lesions because they did not consider these lesions a likely source of mechanical symptoms. 7,9,10,12 In systematic reviews of studies in which tests for SLAP lesions were investigated, authors have indicated that no single test or combination of tests consistently has demonstrated adequate diagnostic utility for identifying SLAP lesions. 13,14 However, in their meta-analysis of SLAP lesion tests using summary receiver operating characteristic (ROC) curves, Meserve et al 15 reported that the active compression and crank tests had better diagnostic utility than the anterior slide test for determining SLAP lesions; the anterior slide test was not recommended for use.…”

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confidence: 99%

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Diagnostic Accuracy of History and Physical Examination of Superior Labrum Anterior-Posterior Lesions

Michener

Doukas

Murphy

et al. 2011

Journal of Athletic Training

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Context: Type I superior labrum anterior-posterior (SLAP) lesions involve degenerative fraying and probably are not the cause of shoulder pain. Type II to IV SLAP lesions are tears of the labrum.Objective: To determine the diagnostic accuracy of patient history and the active compression, anterior slide, and crank tests for type I and type II to IV SLAP lesions.Design: Cohort study. Setting: Clinic. Patients or Other Participants: Fifty-five patients (47 men, 8 women; age = 40.6 ± 15.1 years) presenting with shoulder pain.Intervention(s): For each patient, an orthopaedic surgeon conducted a clinical examination of history of trauma; sudden onset of symptoms; history of popping, clicking, or catching; age; and active compression, crank, and anterior slide tests. The reference standard was the intraoperative diagnosis. The operating surgeon was blinded to the results of the clinical examination.Main Outcome Measure(s): Diagnostic utility was calculated using the receiver operating characteristic curve and area under the curve (AUC), sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (-LR). Forward stepwise binary regression was used to determine a combination of tests for diagnosis.Results: No history item or physical examination test had diagnostic accuracy for type I SLAP lesions (n = 13). The anterior slide test had utility (AUC = 0.70, +LR = 2.25, -LR = 0.44) to confirm and exclude type II to IV SLAP lesions (n = 10). The combination of a history of popping, clicking, or catching and the anterior slide test demonstrated diagnostic utility for confirming type II to IV SLAP lesions (+LR = 6.00).Conclusions: The anterior slide test had limited diagnostic utility for confirming and excluding type II to IV SLAP lesions; diagnostic values indicated only small shifts in probability. However, the combination of the anterior slide test with a history of popping, clicking, or catching had moderate diagnostic utility for confirming type II to IV SLAP lesions. No single item or combination of history items and physical examination tests had diagnostic utility for type I SLAP lesions.

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The Evaluation of Various Physical Examinations for the Diagnosis of Type II Superior Labrum Anterior and Posterior Lesion

Cited by 60 publications

References 24 publications

Examination of the Biceps Tendon

Examination of the Biceps Tendon

Age-related Outcome of Arthroscopic Repair of Isolated Type II Superior Labral Anterior to Posterior Lesions

Diagnostic Accuracy of History and Physical Examination of Superior Labrum Anterior-Posterior Lesions

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