Diagnostic Utility of Clinical Tests for SLAP Lesions: A Systematic Literature Review

Abstract

SLAP lesions are often complex injuries with varied defects and tissue involvement that are challenging to diagnose clinically. The literature notes the need for visualization under arthroscopy for adequate diagnostic accuracy. The goal of this article is to provide a current best-evidence synthesis with regard to physical examination tests used for the diagnosis of SLAP lesions. A literature search yielded 17 studies that investigated the diagnostic utility of clinical tests for SLAP lesions. These studies investigated 19 clinical tests. A narrative review and a systematic review of methodological quality using the QUADAS methodological quality assessment tool yielded 3 high-quality diagnostic utility studies. Current best evidence indicates that a negative finding for the passive compression test provides the therapist with the greatest evidence-based confidence that a SLAP lesion is absent. A positive finding on the anterior apprehension maneuver, the anterior slide test, the Jobe relocation test, the passive compression test, the Speed test, and the Yergason test or a combination of positive findings on the Jobe relocation test and the active compression test or the Jobe relocation test and the anterior apprehension maneuver provides the therapist with the research-based confidence required to rule in a SLAP lesion. For ruling in a SLAP lesion, the greatest diagnostic value should likely be placed on a positive finding on the passive compression test. Suggestions for future research are provided.