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Test library › Shoulder & upper arm

Clinical tests for SLAP lesion, compared

A tear of the top of the labrum, the rim of cartilage around the shoulder socket, where the long head of biceps attaches. SLAP stands for superior labrum, anterior to posterior.

The 3 tests in the library for SLAP lesion, side by side, each with the published accuracy figures that exist for it. Click a test for what each result means, any caution, and the source.

TestSensitivitySpecificityLR+LR−Verdict
Crank test46%72%1.640.75A weak test on its own
O'Brien's / active compression test65%50%1.30.7A weak test on its own
Speed's test20%88%1.670.91A weak test on its own

Reading the table

A high LR+ makes a positive result useful for ruling the condition in; a low LR− makes a negative result useful for ruling it out. A test can be good in one direction and weak in the other, and the figures come from different studies and patient groups, so compare them with care.

No single clinical test reliably rules a SLAP lesion in or out.

Tests for the same problem are rarely independent, so a second positive adds much less than its own figure suggests. Do not multiply their figures together. Where a combination has been tested as a cluster or a decision rule, Rule It In, Rule It Out gives that published result.

To turn a figure into a probability for your patient, use the probability calculator.

Get the book for the shoulder questions that matter: neck or shoulder, a painful cuff or a torn one, and an unstable joint or the labrum

This page gives the published figures. Rule It In, Rule It Out adds how to do each test, what counts as positive, how to read the result, and, where studied, whether combining tests helps.

Coming in late 2026 as a PDF and a paperback. Join the list to hear when it's out

One study, one test, once a month

Rule It In is a free evidence letter for musculoskeletal clinicians: one recent study explained, one examination test with its real numbers. From Trokos, publisher of Rule It In, Rule It Out.