The SLAP apprehension test is generally used to test the integrity of the glenohumeral joint capsule or to assess glenohumeral instability in an anterior direction. This test was described by Berg and Ciullo in 1998 and was developed after 2 patients described cervical spine and shoulder pain and a click associated with turning a steering wheel Le. horizontal flexion and internal rotation after RTA. Arthroscopy revealed the presence of a type II SLAP lesion in both patients.
Test
The patient is examined in sitting or standing. The arm is horizontally flexed across the chest with the elbow extended and the forearm pronated (thumb-down). This may cause pain in the area of the bicipital groove with or without an audible or palpable click. It should then be repeated with the arm supinated (thumb up).
The SLAP-prehension test works on the basic premise that elbow extension and forearm pronation put tension on the tendon of the long head of the biceps. As scapula protraction becomes limited due to the clavicle further horizontal flexion will entrap an unstable labral- bicipital complex between the glenoid and the humeral head causing pain. Tension is reduced with supination allowing the labrum and biceps to reduce therefore resulting in a decrease in pain.
Positive
Pain reproduced in the pronated position should decrease or be eliminated in the supinated test position. No decrease=negative or indeterminate.
References
Posterior Drawer Test
