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So we have images on a 17-year-old baseball player who

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is having pain after sliding on the field during a game.

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And the point I want to make here is the relationship between

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the long head of biceps tendon origin and the superior labrum.

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So we have the superior glenoid rim, and then at

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the top of the superior glenoid rim, we have this

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small projection called the supraglenoid tubercle.

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The long head of biceps tendon takes

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off from the bone in that location.

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It has also attachments to the superior labrum, and that's

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the reason why traction of the long head of biceps tendon

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is one of the main pathomechanics of superior labral tissue.

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Now, we have contrast inside the joint.

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This is an MR arthrogram, oblique coronal

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T1 weighted sequence without fat saturation.

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So, the contrast is bright inside the joint space, and

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we see how there is contrast extending at the interface

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between the labrum and the superior glenoid rim.

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So, This is abnormal, this collection of contrasts

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interposed between the superior labrum and the bone.

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In the axial plane, in that same location, we can see the

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extension of the contrast interposed between the free margin

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of the labrum, right there, and the base of the labrum.

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This has been called the audiobook sign, where the

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bright signal intensity is the contrast interposed between

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the two labral portions, the free margin and the base.

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In this patient, interestingly enough,

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we see the contrast collecting locally.

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At the level of the anterosuperior quadrant, and

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we'll be seeing that that corresponds to a paralabral

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cyst that is filling with contrast right there.

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So we have a paralabral cyst adjacent

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to the root of the coracoid process.

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It's not causing any damage.

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Mass effect or impingement, no effect upon the suprascapular

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neurovascular bundle, but it's a very good sign to feel

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reassured that indeed this is a tear of the superior labrum.

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Now, the extension is anterior to the long head of biceps

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origin and posterior to the long head of biceps origin,

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and that's the name that we have for this lesion is

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SLAP tear, superior labrum, anterior to posterior tears.

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patient is to the anterosuperior quadrant, and that's what

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we're seeing here in the, uh, oblique coronal images.

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You see the collection of contrast material

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within the substance of the anterosuperior labrum.

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This makes this tear SLAP type five, where the

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extension of the tear is to the anterosuperior quadrant.

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Again, let's check that in the consecutive axial images, and you

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can see the extension of the tear to involve the anterior labrum.

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SLAP type 5 in a baseball player who sustained

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an injury while playing on the field.