Open AccessUSE of CLINICAL TEST CLUSTERS VERSUS ADVANCED IMAGING STUDIES in the MANAGEMENT of PATIENTS with a SUSPECTED SLAP TEAR
Author(s) -
Richard Clark,
Chasiti C. Chandler,
Andrew C. Fuqua,
Kelly Glymph,
Grayson C. Lambert,
Katherine J. Rigney
Publication year - 2019
Publication title -
international journal of sports physical therapy
Language(s) - English
Resource type - Journals
ISSN - 2159-2896
DOI - 10.26603/ijspt20190345
Subject(s) - medicine , arthrogram , labrum , magnetic resonance imaging , biceps , gold standard (test) , lesion , radiology , population , surgery , arthroscopy , environmental health
The Magnetic Resonance Arthrogram (MRA) has served as the gold standard for identifying patients with possible Superior Labrum Anterior-Posterior (SLAP) lesions and are often required by orthopaedic surgeons prior to clinical evaluation. However, as the literature shows MRA sensitivity as 0.65-0.98, and specificity between 0.80-1.00, there is still room for misinterpretation of the imaging study, and potential mismanagement of a patient who may or may not exhibit a true SLAP lesion. It is proposed that by grouping a series of clinical special tests it may be possible to develop greater sensitivity in identifying a SLAP lesion, resulting in the ability to better manage this patient population, thus avoiding unnecessary and costly imaging studies and decreased referrals to surgical specialists. The purpose of this study is to examine specific combinations of SLAP lesion special tests and identify which clusters of tests have the highest sensitivity and specificities. This may allow therapists to improve the management of their patients by reliably diagnosing a SLAP lesion and referring only those who may need surgery to a physician.