Superior Labral Anterior Posterior Lesion: Sensitivity and Specificity

Introduction: aka SLAP lesion. From tearing the superior aspect of the labrum in the glenohumeral joint of the shoulder.

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The sensitivity and specificity of findings for Superior Labral Anterior Posterior Lesion are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Biceps Load II Test	90%	96%	with the patient supine, the arm is placed in 120° abduction, and the elbow is placed in 90° flexion. The patient is asked to resist the lateral force applied by the examiner. Study: JAMA. 2004 Oct 27;292(16):1989-99. PMID: 15507585
Zaslav Test	88%	96%	aka internal rotation resistance strength: with the patient standing or sitting, the humerus in 90° abduction and 80° external rotation. The patient is asked to resist an external rotation force applied by the examiner, then to resist an applied internal rotation force. Study: JAMA. 2004 Oct 27;292(16):1989-99. PMID: 15507585
Mimori Test	100%	90%	the arm is placed in 90° abduction, the elbow in 90° flexion, and the forearm in maximum supination. To provoke symptoms, the examiner moves the forearm into maximum pronation. NOTE: small study Study: JAMA. 2004 Oct 27;292(16):1989-99. PMID: 15507585

Specific Findings

Biceps Load I Test

83%

98%

with the patient supine, the arm is placed in 90° abduction, and the elbow is placed in 90° flexion. The patient is asked to resist the lateral force applied by the examiner.

Study: JAMA. 2004 Oct 27;292(16):1989-99. PMID: 15507585

Negative Findings

Anterior Slide Test

83%

Patient stands with hands on hips. One of the examiner's hands is placed over the shouler and the other hand behind the elbow. A force is then applied anteriorly and superiorly, and the patient is asked to push back against the force. The test is positive if pain is localised to the anterosuperior aspect of the shoulder, if there is a pop or a click in that region, or if the maneuver reproduces that patient's symptoms.

Study: JAMA. 2004 Oct 27;292(16):1989-99. PMID: 15507585

Speed Test

32%

61%

The patient's elbow is flexed 20 to 30 degrees with the forearm in supination and the arm in about 60 degrees of flexion. The examiner resists forward flexion of the arm while palpating the patient's biceps tendon over the anterior aspect of the shoulder.

NOTE: odds ratio CI includes 1!

Study: Br J Sports Med. 2008 Feb;42(2):80-92. PMID: 17720798

Poorly Diagnostic Findings

Finding	Sensitivity	Specificity	Comments, Study
Yergason's Test	43%	79%	for Proximal Biceps Tendon Tear OR SLAP Lesion In this test, the patient's elbow is flexed to 90 degrees with the thumb up. The examiner grasps the wrist, resisting attempts by the patient to actively supinate the arm and flex the elbow. Pain with this maneuver indicates biceps tendonitis. Study: Arthroscopy. 2004 Mar;20(3):231-6. PMID: 15007311
Compression Rotation test	24%	76%	Study: JAMA. 2004 Oct 27;292(16):1989-99. PMID: 15507585
Crank Test	46%	56%	The patient's shoulder is abducted 90 degrees and slowly internally rotated while a gentle axial load is applied through the glenohumeral joint. The test is considered positive if the patient reports pain, catching, or grinding in the shoulder. Study: JAMA. 2004 Oct 27;292(16):1989-99. PMID: 15507585
O'Brien Test	47%	55%	aka active compression test: The patient's shoulder is held in 90 degrees of forward flexion, 30 to 45 degrees of horizontal adduction and maximal internal rotation. The examiner grabs the patient's wrist and resists the patient's attempt to horizontally adduct and forward flex the shoulder. Study: JAMA. 2004 Oct 27;292(16):1989-99. PMID: 15507585