SHART: shoulder hyperabduction radiological test

Knee Surg Sports Traumatol Arthrosc. 2011 Dec;19(12):2080-4. doi: 10.1007/s00167-011-1438-8. Epub 2011 Feb 22.


Purpose: To evaluate and quantify laxity of the inferior glenohumeral ligament (IGHL) in post-traumatic anterior instability of the shoulder with the shoulder hyperabduction radiological test (SHART) and correlate it with arthroscopic findings.

Methods: This prospective study included 21 patients undergoing arthroscopic stabilization for anteroinferior shoulder instability. The SHART test was performed as follows: a bilateral AP radiograph was performed in the supine position, and radiographs were compared. The shoulder was positioned in passive maximum abduction in neutral rotation, and neither general nor regional anesthesia was used. The angle between the axis of the humeral shaft and the line drawn between the lateral border of the scapular tubercle and the inferior edge of the glenoid fossa was measured. During arthroscopy, IGHL distension was classified into 4 stages according to the Detrisac classification. Extensive distension was considered to be the stages 3 and 4.

Results: The correlation between the SHART test and Detrisac staging was found to be statistically significant (P = 0.02). In the presence of a difference of more than 15° between the pathological and the contralateral shoulder on radiographs, the SHART test shows 87% of IGHL distension, Detrisac stages 3 and 4.

Conclusion: We suggest that the SHART test should be added to conventional preoperative imaging tests for anterior instability.

MeSH terms

  • Adolescent
  • Adult
  • Arthroscopy / methods*
  • Athletic Injuries / diagnostic imaging
  • Athletic Injuries / physiopathology
  • Athletic Injuries / surgery
  • Female
  • Humans
  • Joint Instability / diagnostic imaging*
  • Joint Instability / physiopathology*
  • Joint Instability / surgery
  • Ligaments, Articular / diagnostic imaging*
  • Ligaments, Articular / physiopathology*
  • Male
  • Predictive Value of Tests
  • Prospective Studies
  • Radiography
  • Range of Motion, Articular / physiology*
  • Sensitivity and Specificity
  • Shoulder Joint / diagnostic imaging*
  • Shoulder Joint / injuries
  • Shoulder Joint / physiopathology*
  • Shoulder Joint / surgery
  • Statistics, Nonparametric
  • Supine Position