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Findings: Axial (A, B) and coronal (C) T1-weighted images from an MR arthrogram demonstrate contrast material interposed between the superior labrum and the glenoid (arrows). The labrum is displaced (arrowhead). This appearance is consistent with a partial detachment of the superior labrum extending from anterior to posterior (SLAP) lesion.

Diagnosis: SLAP lesion.

Discussion: SLAP lesions are tears of the superior labrum which may occur following acute trauma such as a fall on an outstretched arm. These lesions are also seen in the overhead throwing athlete. The tears are classified according to the extent of injury.(1) In Type I lesions there is fraying of the free edge of the superior labrum. In Type II lesions the superior labrum and biceps tendon are detached from the glenoid. Type III lesions are characterized by a bucket-handle tear of the superior labrum with an intact biceps tendon. A type IV lesion is present when there is a bucket handle tear of the superior labrum with associated extension into the biceps tendon. Diagnosis must take into consideration the patient's age since central detachment of the superior labrum may occur as a part of the normal aging process.

References:

1. Cartland JP, Crues III JV, Stauffer A, Nottage W, Ryu RKN.
   MR Imaging in the Evaluation of SLAP Injuries of the Shoulder:
   Findings in 10 Patients. AJR 1992; 159:787-792.

2. Monu JUV, Pope TL, Chabon SJ, Vanarthos WJ. MR Diagnosis of
   Superior Labral Anterior Posterior (SLAP) Injuries of the Glenoid Labrum:
   Value of Routine Imaging Without Intraarticular Injection of Contrast Material.
   AJR 1994; 163:1425-1429.

3. Hodler J, Kursunoglu-Brahme S, Flannigan B, Snyder SJ, Karzel RP,
   Resnick D. Injuries of the Superior Portion of the Glenoid Labrum Involving the
   Insertion of the Biceps Tendon: MR Imaging Findings in Nine Cases.
   AJR 1992; 159:565-568.

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