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This Article Full Text Full Text (PDF) All Versions of this Article: 33/9/1315    most recent 0363546504273050v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Myers, T. H. Articles by Andrews, J. R. Search for Related Content PubMed PubMed Citation Articles by Myers, T. H. Articles by Andrews, J. R. Related Collections Epidemiology Shoulder

The Resisted Supination External Rotation Test

A New Test for the Diagnosis of Superior Labral Anterior Posterior Lesions

Thomas H. Myers, MD^*,, Jason R. Zemanovic, MD and James R. Andrews, MD

From the Atlanta Sports Medicine and Orthopaedic Center, Atlanta, Georgia, and the American Sports Medicine Institute, Birmingham, Alabama

^* Address correspondence to Thomas H. Myers, MD, Atlanta Sports Medicine and Orthopaedic Center, 3200 Downwood Circle, Suite 500, Atlanta, GA 30327 (email: tmyers12{at}bellsouth.net).

Purpose: To evaluate a new clinical test, the resisted supination external rotation test, for the diagnosis of superior labral anterior posterior lesions of the shoulder.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Methods: Forty athletes (average age, 23.9 years) with activity-related shoulder pain were enrolled in the study. The patients underwent 3 different tests designed specifically to detect superior labral anterior posterior lesions (the resisted supination external rotation test, the crank test, and the active compression test); the tests were performed in a random order on the affected shoulder. The results of the tests were compared with arthroscopic findings.

Results: Out of 40 athletes, 29 (72.5%) had superior labral anterior posterior tears. The resisted supination external rotation test had the highest sensitivity (82.8%), specificity (81.8%), positive predictive value (92.3%), negative predictive value (64.3%), and diagnostic accuracy (82.5%) of all tests performed.

Conclusion: By re-creating the peel-back mechanism, the resisted supination external rotation test is more accurate than 2 other commonly used physical examination tests designed to diagnose superior labral anterior posterior tears in overhead-throwing athletes. By using this test in the context of a thorough clinical history and physical examination, lesions of the superior labrum can be more reliably diagnosed.

Key Words: superior labral anterior posterior (SLAP) lesion • superior labral anterior posterior (SLAP) test • physical examination • peel-back mechanism • superior labrum • overhead-throwing athletes

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