Proximal Biceps Pathology and SLAP Lesions

Shoulder pain is a frequent complaint in overhead athletes or patient with overhead activities and SLAP lesion is a possible cause of their dysfunction. The pathological cascade leading to the SLAP lesion is a combination of posterior inferior capsular contracture and scapular dyskinesia. These abnormalities are responsible for the peel back phenomenon with detachment of the biceps-labrum complex leading to biceps-labrum instability. Different sensitivity and specificity of the physical exam have been published. It is useful to complement the clinical exam with MRI or MR Arthrogram to diagnose the lesion, however arthroscopy will confirm the diagnosis. Some of SLAP lesions may require surgical treatment to restore biceps-labrum function and to treat the associated pathology, but treatment of SLAP lesion remains controversial.