Superior Labral Tear of the Shoulder (SLAP tear)
Diagnosis: Superior Labral Tear of the Shoulder (SLAP tear)
Clinical Keywords: labrum, biceps, throwing, tear
- Superior labral tears can be a source of pain, especially in athletes that throw overhead like baseball players
- SLAP tears can be difficult to diagnose accurately
The glenoid labrum is a ring-like structure that encircles the cup of the shoulder joint. It is felt to provide additional stability to the joint since the shoulder has very large range of motion. However, because of this significant degree of motion, the labrum is susceptible to injury. Different parts of the labrum can be injured through different mechanisms of injury. A superior labral tear is sometimes referred to as a SLAP tear which is an acronym that stands for Superior Labrum Anterior to Posterior. In plain language, this means that this injury often is a tear of the top portion (superior portion) of the labrum that extends both in front of and behind the area of the labrum where the biceps tendon attaches to it and to the shoulder blade. There are different ways that this portion of the labrum can be injured including a fall on an outstretched hand or through overhead throwing where the biceps tendon actually pulls this part of the labrum off of the bone.
On an MRI, a SLAP tear is diagnosed when the top part of the labrum is brighter looking than normal and when it appears to be detached from its normal bone attachment.
This part of the labrum can also degenerate as we age and with arthritis so making a diagnosis of a superior labral tear can be difficult with imaging. There is even a study suggesting that it is difficult for shoulder surgeons to agree on this diagnosis when looking at the same arthroscopic images. As with most imaging findings, correlation with physical signs and symptoms and the history of injury improve the ability to diagnose this injury accurately.
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