Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA 23298, USA.
J Athl Train. 2011 Jul-Aug;46(4):343-8. doi: 10.4085/1062-6050-46.4.343.
Type I superior labrum anterior-posterior (SLAP) lesions involve degenerative fraying and probably are not the cause of shoulder pain. Type II to IV SLAP lesions are tears of the labrum.
To determine the diagnostic accuracy of patient history and the active compression, anterior slide, and crank tests for type I and type II to IV SLAP lesions.
Cohort study.
Clinic.
Fifty-five patients (47 men, 8 women; age = 40.6 ± 15.1 years) presenting with shoulder pain.
INTERVENTION(S): For each patient, an orthopaedic surgeon conducted a clinical examination of history of trauma; sudden onset of symptoms; history of popping, clicking, or catching; age; and active compression, crank, and anterior slide tests. The reference standard was the intraoperative diagnosis. The operating surgeon was blinded to the results of the clinical examination.
MAIN OUTCOME MEASURE(S): Diagnostic utility was calculated using the receiver operating characteristic curve and area under the curve (AUC), sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (-LR). Forward stepwise binary regression was used to determine a combination of tests for diagnosis.
No history item or physical examination test had diagnostic accuracy for type I SLAP lesions (n = 13). The anterior slide test had utility (AUC = 0.70, +LR = 2.25, -LR = 0.44) to confirm and exclude type II to IV SLAP lesions (n = 10). The combination of a history of popping, clicking, or catching and the anterior slide test demonstrated diagnostic utility for confirming type II to IV SLAP lesions (+LR = 6.00).
The anterior slide test had limited diagnostic utility for confirming and excluding type II to IV SLAP lesions; diagnostic values indicated only small shifts in probability. However, the combination of the anterior slide test with a history of popping, clicking, or catching had moderate diagnostic utility for confirming type II to IV SLAP lesions. No single item or combination of history items and physical examination tests had diagnostic utility for type I SLAP lesions.
I 型上盂唇前后向（SLAP）病变涉及退行性磨损，可能不是肩部疼痛的原因。II 型至 IV 型 SLAP 病变是盂唇撕裂。
确定病史、主动压迫、前滑和曲柄试验对 I 型和 II 型至 IV 型 SLAP 病变的诊断准确性。
队列研究。
诊所。
55 名患者（47 名男性，8 名女性；年龄=40.6±15.1 岁）出现肩部疼痛。
每位患者由骨科医生进行临床检查，包括外伤史；症状突然发作；弹响、喀哒声或捕捉史；年龄；以及主动压迫、曲柄和前滑试验。参考标准是术中诊断。手术医生对临床检查结果不知情。
使用受试者工作特征曲线和曲线下面积（AUC）、灵敏度、特异性、阳性似然比（+LR）和阴性似然比（-LR）计算诊断效用。采用向前逐步二元回归确定诊断的联合测试组合。
没有任何病史项目或体格检查试验对 I 型 SLAP 病变有诊断准确性（n=13）。前滑试验对确认和排除 II 型至 IV 型 SLAP 病变（n=10）具有效用（AUC=0.70，+LR=2.25，-LR=0.44）。弹响、喀哒声或捕捉病史与前滑试验的组合对确认 II 型至 IV 型 SLAP 病变具有诊断效用（+LR=6.00）。
前滑试验对确认和排除 II 型至 IV 型 SLAP 病变具有有限的诊断效用；诊断值仅表明概率略有变化。然而，前滑试验与弹响、喀哒声或捕捉病史的组合对确认 II 型至 IV 型 SLAP 病变具有中等诊断效用。没有单一项目或病史项目和体格检查试验的组合对 I 型 SLAP 病变具有诊断效用。
