Question:My orthopedic doctor thinks I've torn the labrum in my left shoulder. I don't really want to have expensive tests done to find out for sure. Aren't there some simple tests that can diagnose this problem?
Answer:The most definitive test is an arthroscopic exam. The doctor inserts a long, thin needle into the area with a tiny TV camera on the end. The camera transmits a live video picture of the structures to a monitor. The surgeon can then repair the damage at the same time.
Before surgery (or if surgery isn't done), there are some clinical tests that can be done to help diagnose this problem. Unfortunately, there isn't one single test that can tell for sure when there is a labral tear. Recently, a study from Korea tested 10 different tests used to examine the shoulder.
They found that combining a couple tests together helped improve the chances of identifying a labral tear. They were able to specifically find which tests work well together and report them. Physicians, physical therapists, and athletic trainers use these tests routinely.
It's likely that your surgeon used some of these tests along with your history and symptoms to make the tentative diagnosis. You may not need any further testing if you aren't planning to have surgery. A rehab program can be prescribed on a trial basis. If you don't see any improvements and you want to consider have a shoulder reconstruction, then further testing may be needed.Joo Han Oh, MD, et al. The Evaluation of Various Physical Examinations for the Diagnosis of Type II Superior Labrum Anterior and Posterior Lesion. In The American Journal of Sports Medicine. February 2008. Vol. 36. No. 2. Pp. 353-359.
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