A new SLAP test: the supine flexion resistance test

Area of Science:

• Orthopedic Surgery
• Diagnostic Imaging
• Sports Medicine

Background:

• Superior Labrum Anterior and Posterior (SLAP) lesions are common shoulder injuries.
• Accurate diagnosis of SLAP lesions is crucial for effective treatment and patient outcomes.
• Existing clinical tests like Speed's test and O'Brien test have limitations in specificity.

Purpose of the Study:

• To introduce and evaluate a novel supine flexion resistance test for detecting SLAP lesions.
• To compare the diagnostic accuracy (sensitivity, specificity, predictive values) of the new test against Speed's and O'Brien tests.
• To determine the effectiveness of the new test in identifying specific types of SLAP lesions and associated injuries.

Main Methods:

• A cohort of 150 patients with shoulder pain underwent a comprehensive shoulder examination.
• All patients were assessed using Speed's test, O'Brien test, and the new supine flexion resistance test.
• Clinical findings were correlated with arthroscopic visualization to confirm the presence and type of SLAP lesions.

Main Results:

• The supine flexion resistance test demonstrated a sensitivity of 80% and specificity of 69%.
• Speed's test had 60% sensitivity and 38% specificity; O'Brien test had 94% sensitivity and 28% specificity.
• For isolated SLAP lesions, the new test achieved 92% sensitivity, and for isolated supraspinatus tears, it showed 75% specificity.

Conclusions:

• The supine flexion resistance test is more specific than Speed's and O'Brien tests for diagnosing SLAP lesions.
• The new test is particularly effective for identifying type II SLAP lesions.
• Its high specificity aids in eliminating false positives from more sensitive but less specific clinical evaluations.