Musculoskeletal ImagingSlap lesion
a name given to a condition characterized by superior labral anterior and posterior (SLAP) tear. This injury is often seen after forced abduction of the arm, as in athletes who use repetitive overarm motions. The superior portion of the glenoid labrum and sometimes the biceps anchor are involved.
At least seven types are recognized (Table 1).
SLAP lesion, Table 1. Types of SLAP lesion.
| Type | Abnormality |
|---|
| I | Degenerative fraying of the superior portion of the labrum, with the labrum remaining firmly attached to the glenoid rim |
| II | Separation of the superior portion of the glenoid labrum and tendon of the biceps brachii muscle from the glenoid rim |
| III | Bucket-handle tears of the superior portion of the labrum without involvement of the biceps brachii (long head) attachment |
| IV | Bucket-handle tears of the superior protion of the labrum extending into the biceps tendon |
| V | Anteroinferior Bankart lesion that extends upward to include a separation of the biceps tendon |
| VI | Unstable radial of flap tears associated with separation of the biceps anchor |
| VII | Anterior extension of the SLAP lesion beneath the middle glenohumeral ligament |
Computed arthrotomography and MR imaging are used in diagnosing these injuries, although some types of lesions (such as simple fraying of the superior part of the labrum) cannot be visualized by the latter technique. Use of MR arthrography improves diagnostic accuracy and arthroscopy may provide the most definitive information.
Treatment may require excision of part of the glenoid labrum.
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