History

30 y/o male who complains of right shoulder pain that began suddenly on 7/29/03.  While working, patient lowered 40 lbs crate after lifting it from overhead,  injuring his right shoulder.  Pain is occasional, stabbing, located in anterior shoulder.  Pt complains of night pain and weakness of overhead activities.

PE

• Unremarkable neck examination
• ROM 180/140/50
• ABER and stress of supraspinatus painful
• Weak supraspinatus
• No evidence of shoulder instability
• Positive impingement tests
• Positive crepitation of GH joint and O’brien
• No atrophy present

X-Rays

unremarkable

MRI

• Partial supraspinatus tear
• Superior Labrum abnormal
• Small ganglion cyst

Scope

Repair

Discussion

SLAP lesions are tears of the superior labrum which may occur following acute trauma such as a fall on an outstretched arm. These lesions are also seen in the overhead throwing athlete. 

The tears are classified according to the extent of injury.

• (1) In Type I lesions there is fraying of the free edge of the superior labrum. 
• In Type II lesions the superior labrum and biceps tendon are detached from the glenoid. 
• Type III lesions are characterized by a bucket-handle tear of the superior labrum with an intact biceps tendon. 
• A type IV lesion is present when there is a bucket handle tear of the superior labrum with associated extension into the biceps tendon.