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The Resisted Supination External Rotation Test: A New Test for the Diagnosis of Superior Labral Anterior Posterior Lesions

T. H. Myers, J. R. Zemanovic, and J. R. Andrews

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

Study Design: 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.

Conclusion: 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.

at the top; towards the head
at the back; behind
A firm, white structure that forms a ring around the glenoid cavity (the cup of the ball and socket shoulder joint). It deepens the socket, providing stability to the joint.
The labrum is a firm, white structure that forms a ring around the glenoid cavity (the cup of the ball and socket shoulder joint). It deepens the socket, providing stability to the joint.
'key-hole' surgery. Surgery performed via small incisions, using special instruments and a viewing scope..
at the front; in front
References
Am. J. Sports Med., September 1, 2005; 33(9): 1315 - 1320



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Tags: [Clinical] [ Labral Lesions] [View tag cloud]

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