Compression Rotation Test | SLAP Lesions | Shoulder Assessment

Gismervik et al. in the year 2017 performed a rigorous meta-analysis of shoulder tests for SLAP lesions and found the Compression-Rotation Test to be the most accurate test with a sensitivity of 43% and a specificity of 89%. While the test is still rather weak to exclude SLAP lesions, it has a moderate clinical value to confirm a SLAP tear.

In order to perform the Compression-Rotation Test have your patient in supine position, while the examiner is standing on the patient’s affected side. Then bring the patient’s shoulder into ninety degrees of Abduction with the elbow flexed to ninety degrees. The examiner then applies a compression force through the humerus at the elbow and rotates the humerus via the wrist into repeated internal and external rotation in an attempt to trap the torn labrum.

This test is positive in case of catching or snapping, similar to the McMurray test in the knee.

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Other orthopedic tests to assess biceps pathology & SLAP lesions are:

• Active Compression Test of O’Brien
• Yergason’s Test
• Biceps Load I Test
• Biceps Load II Test
• 3-Pack Examination
• Crank Test
• Passive Distraction Test
• Labral Tension Test
• Dynamic Labral Shear Test
• Upper Cut Test
• Supine Flexion Resistance Test
• Anterior Slide Test
• Speeds Test
• Passive Compression Test
• Resisted Supine External Rotation Test

References

Gismervik, S. Ø., Drogset, J. O., Granviken, F., Rø, M., & Leivseth, G. (2017). Physical examination tests of the shoulder: a systematic review and meta-analysis of diagnostic test performance. BMC musculoskeletal disorders, 18(1), 1-9.

Snyder, S. J., Karzel, R. P., Del Pizzo, W., Ferkel, R. D., & Friedman, M. J. (1990). SLAP lesions of the shoulder. Arthroscopy: the journal of arthroscopic & related surgery, 6(4), 274-279.