Non contrast MRI- Good enough for diagnosing SLAP lesions?
Due to the very shallow socket at the glenohumeral joint the labrum plays a key role in passive stability for the joint. The majority of people who have superior labrum anterior posterior (SLAP) tears continue to experience pain and disability until surgical correction is performed. Clinically this shows the importance of early identification so the surgical referral process may get started.
According to this study Non contrast MRI had
· Sensitivity (rule out) 86%
· Specificity (rule in) 13%
The concern is identification of SLAP tears that do not exist.
There are various studies in the literature with differing values but the author indicates that most studies with comparable patient groups tended to more or less agree that the test has a very high sensitivity and low specificity. Those that did not agree had populations that may have been affected by spectrum bias.
Conclusions:
· Non contrast MRI was not suitable as a test for diagnosing SLAP tears
· MR arthrography is a more appropriate choice for diagnosis of SLAP tears
Phillips J, Cook C, Beaty S, Kissenberth M, Siffri P, Hawkins R. Validity of noncontrast magnetic resonance imaging in diagnosing superior labrum anterior-posterior tears. J Shoulder Elbow Surg 2012; 1-6.