A new pain provocation test for superior labral tears of the shoulder

We prospectively evaluated the usefulness of a new pain provocation test to diagnose superior labral tears in 32 patients with diagnosed throwing inju ries of the shoulder. Results of the pain provocation test were compared wi th findings on magnetic resonance arthrography (all 32 patients) and arthro scopic examination (15 patients). In 22 patients, detachment of the superio r labrum was observed on arthrograms, and all of them had positive results on the new pain provocation test. Nine of the other 10 patients had negativ e results on the new pain provocation test. However, 1 of the 10 patients h ad a positive result. Eleven of 15 patients were found to have superior lab ral lesions arthroscopically, and all of them were classified as type II su perior labral anterior posterior lesions. All the 11 patients had positive pain provocation tests. The other four patients without superior labral tea rs on arthroscopic findings had negative results on the new pain provocatio n test. The new pain provocation test identified all patients with detachme nt of the superior labrum confirmed by magnetic resonance arthrography, for a sensitivity of 100%, a specificity of 90%, and an accuracy of 97%. Resul ts of the new pain provocation test were in accord with arthroscopic findin gs in the 15 patients who underwent arthroscopic examination.