Parentis Michael Andrew, Glousman Ronald E, Mohr Karen S, Yocum Lewis A
The Knee Center of Western New York, Amherst, USA.
Am J Sports Med. 2006 Feb;34(2):265-8. doi: 10.1177/0363546505279911. Epub 2005 Oct 11.
Although our understanding of superior labral anterior posterior lesions has grown, the physical diagnosis remains imperfect.
Cohort study (diagnostic); Level of evidence, 2.
To determine the most effective provocative maneuver with which to diagnose superior labral anterior posterior lesions.
A series of 132 consecutive patients scheduled to undergo diagnostic shoulder arthroscopy were examined preoperatively over a 6-month period, and the final diagnosis in each case was made arthroscopically. The following assessments were included: active compression (O'Brien), anterior slide, pain provocation, crank, Jobe relocation, Hawkins, Neer, Speed, and Yergason tests.
The most sensitive diagnostic tools for type II superior labral lesions were the active compression, Hawkins, Speed, Neer, and Jobe relocation tests. When type I and type II lesions were combined, the results were similar. However, none of the sensitive tests were specific for either type I or type II lesions.
The authors' results contradict the current literature regarding provocative testing for both stable and unstable superior labral lesions. There is no single maneuver that can accurately diagnose superior labral anterior posterior lesions; arthroscopy remains the standard by which to diagnose such lesions.
尽管我们对肩胛上盂唇前后部损伤的认识有所提高，但体格检查诊断仍不完善。
队列研究（诊断性）；证据等级，2级。
确定诊断肩胛上盂唇前后部损伤最有效的激发试验。
在6个月期间，对132例计划接受诊断性肩关节镜检查的连续患者进行术前检查，每例患者的最终诊断均通过关节镜检查确定。评估项目包括：主动压迫试验（奥布赖恩试验）、前滑试验、疼痛激发试验、曲柄试验、乔布重新定位试验、霍金斯试验、尼尔试验、斯皮德试验和耶尔加森试验。
对于II型肩胛上盂唇损伤，最敏感的诊断工具是主动压迫试验、霍金斯试验、斯皮德试验、尼尔试验和乔布重新定位试验。当I型和II型损伤合并时，结果相似。然而，这些敏感试验中没有一项对I型或II型损伤具有特异性。
作者的结果与目前关于稳定和不稳定肩胛上盂唇损伤激发试验的文献相矛盾。没有单一的试验能准确诊断肩胛上盂唇前后部损伤；关节镜检查仍然是诊断此类损伤的标准方法。
