title: The chondral print sign: what does it really mean?
abstract: BACKGROUND
  The chondral print (CP) sign is a chondral change on the humeral head underneath the long head of the biceps (LHB) tendon. Several suggested causative links have been described, but the pathologic mechanism remains unclear.
  
  
  METHODS
  We designed this prospective cohort association study of 102 consecutive shoulder arthroscopies to investigate proposed associations of CP with LHB, rotator cuff, labral pathology, and other chondral lesions. Data collection was by a specifically designed pro forma, and statistical analysis was performed.
  
  
  RESULTS
  We identified 24 patients (23.5%) with the CP sign. Patients were a mean age of 58 years. Shoulders with positive CP sign had associated pathologies: 16 superior labral anteroposterior (SLAP) tears, 4 LHB instabilities, and 11 other LHB lesions. We also recorded other chondral lesions, 10 humeral head and 12 on the glenoid surface. The overall arthroscopic appearance of CP signs could be classified into 3 different types. Statistical analysis revealed that the CP sign is not statistically associated with LHB instability, any other LHB pathologies, rotator cuff tears, or instability. The CP sign was statistically positively associated with SLAP lesions (but only if type 1 were included). There was a weak association of CP sign with age and a positive association of SLAP lesions with other (non-CP) humeral chondral lesions.
  
  
  CONCLUSIONS
  Our prospective association study cannot determine the cause of the CP sign. It does not seem to be a reliable sign of LHB instability or of other LHB pathology. There is an association with age and degenerative SLAP lesions.
authors.affiliation: Department of Trauma and Orthopaedics, Royal Free NHS Foundation Hospital, London, UK. Electronic address: peter.domos@googlemail.com.
authors.forename: Peter
authors.initials: P
authors.lastname: Domos
authors.affiliation: Department of Trauma and Orthopaedics, Royal Free NHS Foundation Hospital, London, UK.
authors.forename: Devdatta S
authors.initials: DS
authors.lastname: Neogi
authors.affiliation: Department of Orthopaedic and Trauma Surgery, University Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Umile Giuseppe
authors.initials: UG
authors.lastname: Longo
authors.affiliation: Department of Trauma and Orthopaedics, Royal Free NHS Foundation Hospital, London, UK.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Ahrens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D061165:Glenoid Cavity; D006801:Humans; D058430:Humeral Head; D007593:Joint Instability / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000070636:Rotator Cuff Injuries / Q000503:physiopathology; D012785:Shoulder Joint / Q000503:physiopathology*; D013710:Tendons / Q000503:physiopathology; D055815:Young Adult
keywords: Chondral print sign; SLAP tear; associations; biceps instability; biceps pulley lesion; long head of biceps