How is a SLAP tear in the shoulder diagnosed?

Doctor's Answers 2

Photo of Dr Henry Chan
Dr Henry Chan

Orthopaedic Surgeon

Hi, really sorry to hear about your shoulder injury. SLAP tear means "superior labral tear from anterior to posterior". Labrum is the fibrocartilaginous rim of soft tissue attached around the margin of the shoulder joint (the glenoid cavity). The biceps tendon is also anchored in the superior labrum as well. So the symptoms a SLAP tear are usually pain when the biceps are required, or overhead throwing movement. The pain is especially worse at night, and the patient typically cannot sleep on the affected shoulder.

To diagnose shoulder injuries, I'd recommend a MRI scan, it has a higher resolution and higher sensitivity as compared to ultra-sound scans, we can also assess whether there are any concomitant injuries to the muscles (rotator cuff) and the cartilage in the joint. X rays won't be very helpful and you will end up wasting your money.

Depending on the severity of the tear and the symptoms, treatment can be divided into 2 types:

1. Conservative treatment - we will provide anti-inflammatory medication and physiotherapy, however, it is usually not very effective in the treatment of established SLAP tears.

2. Surgical treatment - we will repair the SLAP tears using special minimally invasive techniques (suture anchors) via 3 small key-hole incisions in the shoulder region. This keyhole surgery will pose the least surgical trauma and risk to the patient and allow the patient to rehabilitate faster with lesser pain.

The wound will take about 2 weeks to heal and then the patient can undergo rehabilitation to regain the movement and the strength of the shoulder. The pain would have been much improved as well and the patients can return to pretty normal function and their daily routine in about 6 weeks to 3 months.

Hope I clear some doubts for you.

Cheers,

Dr. Henry Chan

Thanks for your question - I won't repeat what Dr Henry has already mentioned in his excellent answer, but perhaps I can add to it.

While I appreciate your concerns about a possible SLAP lesion, there are other potential issues that can happen around a shoulder that might cause ongoing pain.

This includes a AC joint issue, tendinopathy, impingement, a tendon tear, a frozen shoulder, a nerve injury and so on. In the first instance, the humble X-ray is still a good test to see if there is anything significant going on with the joint and also, if done while carrying a weight, we can see if there is an AC joint issue.

The ultrasound is excellent for imaging of the tendons, the AC joint and also for a functional assessment of the shoulder. If you decide to go for an MRI, please consider an arthrogram, where contrast is injected into the shoulder to highlight the injuries.

Many issues around the shoulder can be treated with physiotherapy, injections or adjuvant treatments such as acupuncture. Before you embark on a treatment, perhaps I can suggest a more thorough assessment by an MSK/Sports physician/physiotherapist. They can help you with the initial part of you journey.

I hope this helps.

BW

Dr Dinesh

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