A new SLAP test: the supine flexion resistance test

Arthroscopy. 2008 May;24(5):500-5. doi: 10.1016/j.arthro.2007.11.017. Epub 2008 Jan 30.

Abstract

Purpose: This study describes a new test to detect SLAP lesions. The sensitivity, specificity, and positive and negative predictive values with respect to the diagnosis of a SLAP lesion were determined in comparison to Speed's test and the O'Brien test.

Methods: One hundred fifty patients presenting for arthroscopic surgery with persisting pain or functional disability of the shoulder underwent a complete shoulder examination. All patients underwent Speed's test, the O'Brien test, and the new supine flexion resistance test. The clinical results of the tests were correlated with the presence of a SLAP lesion by direct arthroscopic visualization.

Results: The supine flexion resistance test had a sensitivity of 80% and a specificity of 69%, whereas Speed's test and the O'Brien test had sensitivities of 60% and 94%, respectively, and specificities of 38% and 28%, respectively. Regarding isolated SLAP lesions, the supine flexion resistance test was highly sensitive, with a sensitivity of 92% (58% for Speed's test and 75% for the O'Brien test). For isolated tears of the supraspinatus, the specificity of the supine flexion resistance test was 75% (14% for Speed's test and 17% for the O'Brien test).

Conclusions: Compared with the O'Brien test and Speed's test, the supine flexion resistance test proves to be more specific, with a specificity of 69% for the whole study population (28% for the O'Brien test and 38% for Speed's test) and with a specificity of 75% for the group of patients with isolated supraspinatus lesions (17% for the O'Brien test and 14% for Speed's test). The new test is a useful and effective test for detecting type II SLAP lesions. The high specificity enables the elimination of false-positive results of other clinical tests that are more sensitive but not specific.

Level of evidence: Level II, development of diagnostic criteria with consecutive patients and universally applied gold standard.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthroscopy
  • Diagnosis, Differential
  • Female
  • Humans
  • Joint Diseases / diagnosis*
  • Joint Instability / diagnosis
  • Male
  • Middle Aged
  • Orthopedics / methods*
  • Orthopedics / trends
  • Prospective Studies
  • Sensitivity and Specificity
  • Shoulder Joint*
  • Supine Position