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.
Atlanta Sports Medicine and Orthopaedic Center, 3200 Downwood Circle, Suite 500, Atlanta, GA 30327, USA. tmyers12@bellsouth.net
Thomas H
TH
Myers
Jason R
JR
Zemanovic
James R
JR
Andrews
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