The resisted supination external rotation test: a new test for the diagnosis of superior labral anterior posterior lesions.
OBJECTIVE
To evaluate a new clinical test, the resisted supination external rotation test, for the diagnosis of superior labral anterior posterior lesions of the shoulder.


METHODS
Cohort study (diagnosis); Level of evidence, 2.


METHODS
Forty athletes (average age, 23.9 years) with activity-related shoulder pain were enrolled in the study. The patients underwent 3 different tests designed specifically to detect superior labral anterior posterior lesions (the resisted supination external rotation test, the crank test, and the active compression test); the tests were performed in a random order on the affected shoulder. The results of the tests were compared with arthroscopic findings.


RESULTS
Out of 40 athletes, 29 (72.5%) had superior labral anterior posterior tears. The resisted supination external rotation test had the highest sensitivity (82.8%), specificity (81.8%), positive predictive value (92.3%), negative predictive value (64.3%), and diagnostic accuracy (82.5%) of all tests performed.


CONCLUSIONS
By re-creating the peel-back mechanism, the resisted supination external rotation test is more accurate than 2 other commonly used physical examination tests designed to diagnose superior labral anterior posterior tears in overhead-throwing athletes. By using this test in the context of a thorough clinical history and physical examination, lesions of the superior labrum can be more reliably diagnosed.
Myers
Thomas H
TH
Atlanta Sports Medicine and Orthopaedic Center, 3200 Downwood Circle, Suite 500, Atlanta, GA 30327, USA. tmyers12@bellsouth.net
Zemanovic
Jason R
JR
Andrews
James R
JR
D000173:Acromioclavicular Joint / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001484:Baseball / Q000293:injuries; D005260:Female; D005538:Football / Q000293:injuries; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012399:Rotation; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology; D020069:Shoulder Pain / Q000175:diagnosis / Q000503:physiopathology; D012865:Skiing / Q000293:injuries; D013484:Supination