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Clinical characteristics of patients with posterosuperior labral tear: a comparison with patients with other shoulder disorders

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Background Among the various causes of shoulder pain, the glenoid labral tear is likely to be overlooked due to its ambiguous symptoms, especially if clinicians do not have a prior… Click to show full abstract

Background Among the various causes of shoulder pain, the glenoid labral tear is likely to be overlooked due to its ambiguous symptoms, especially if clinicians do not have a prior suspicion, making it difficult to diagnose, unlike adhesive capsulitis or a rotator cuff tear. Therefore, the aim of this study was to evaluate the clinical features of posterosuperior (PS) labral tear. Methods Of the patients who visited the clinic, the medical records of patients with shoulder pain who underwent shoulder magnetic resonance imaging or ultrasound after intra-articular injection (arthrosonography) were investigated retrospectively. Based on these criteria, a total of 120 patients with adhesive capsulitis, rotator cuff problem, or PS labral tear were included for analysis in this study. Results In the physical examination, all patients with a PS labral tear were positive on the O’Brien test (13/13, 100%) and the external rotation (ER) test with the upper arm in the abduction position (abduction and ER [ABER] test) (13/13, 100%), but they were negative on other tests, such as the Hawkins–Kennedy (1/13, 7.69%) and Neer (0/13, 0.00%) tests. Except one patient, all patients with a PS labral tear were negative on the ER test with the upper arm in the neutral position (ER test) (1/13, 7.69%). In the clinical history, all patients with a PS labral tear had a characteristic episode of shoulder pain occurring in the excessive ABER posture. Conclusion In patients with characteristic physical findings (no definite loss of motion of the shoulder joint, negative in an ER test, but positive in an ABER test and O’Brien test), and with a clinical history of PS labral tear (a history of pain occurring with the excessive ABER posture), clinicians need to have a suspicion of PS labral tear and to identify the PS labral tear using MRI or arthrosonography

Keywords: test; patients shoulder; posterosuperior labral; shoulder pain; labral tear

Journal Title: Journal of Pain Research
Year Published: 2018

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