How Are SLAP Tears Diagnosed?

Identifying and adequately diagnosing a SLAP tear can be a challenging endeavor. The symptoms are similar to other shoulder lesions that can be sustained in addition to the SLAP tear.

Several diagnostic methods are available, although shoulder arthroscopy seems to be the most effective. This is because an arthroscope (a small tube fitted with a camera and light source) can provide a more detailed internal image of the sustained damage. Other methods may be helpful but lack the accuracy of shoulder arthroscopic diagnosis. 

The diagnostic process follows a three-step clinical approach and can indicate the treatment that will be required.

Patient Medical History

Several details need to be established while evaluating a patient's medical history, ranging from potential previous treatments to present-day symptoms and their evolution. Such information may include:

• Activities involving overhead motions – Athletic activities such as baseball, football, or swimming require repeated throwing-like actions that can wear down the shoulder joint and lead to a SLAP tear. Lifting heavy objects overhead in non-athletic activities can also lead to labral lesions.
• Initial source – Because the damage is sustained over prolonged periods through repetitive overhead movements, it may be challenging to establish where the pain originally began.
• Discomfort location – Patients usually cite an acute and deep pain that is difficult to locate, at times accompanied by uncommon popping or clicking sounds and sensations of stiffness and grinding within the shoulder joint.

Physical Exam

As the most hands-on approach, doctors perform physical exams to evaluate joint strength, stability, and the shoulder's range of motion. The neck and head may also be inspected to ensure that a pinched nerve isn’t causing the pain. While there are particular tests that doctors may employ to diagnose a SLAP injury, opinions on the reliability and accuracy of these methods vary among specialists.

Physical exams present several challenges because they are not always precise, and some labrum lesions may not be accurately identified. Because of this ambiguity in outcomes, image scanning is usually recommended to obtain a clearer diagnosis.

Imaging Scans

X-rays aren't regarded as the most effective diagnostic tool because cartilage damage isn't usually imaged when using this method. On the other hand, X-rays are useful in ruling out other bone-related injuries affecting the shoulder.

MRI scans are considered the most efficient noninvasive method for SLAP tear diagnosis. Because of the shoulder's complex structure, MRI scans can also identify additional problems stemming from ligament, tendon, and muscle issues. Conversely, MRI scans may encounter difficulties in pinpointing minute tears or produce a false positive. In such cases, minimally invasive methods such as shoulder arthroscopy could be employed for a more detailed analysis.