Double oreo cookie sign (glenoid labrum)
The double oreo cookie sign refers to the presence of two hyperintese lines in the superior glenoid labrum, one of which representing a superior labral tear and the other a physiological sublabral recess 1, 2.
This pattern is likened to a oreo cookie with two layers of (white) cream and three layers of (dark) cookie. The white lines represent fluid in the labral tear and the recess; the dark structures represent the glenoid cortex and the labrum (twice) 2.
While the double oreo cookie sign is highly specific of a SLAP tear, it's only present in about 20% of patients with a SLAP tear type 2-4 and therefore seems to add little to the sensitivity for SLAP tears on T2-weighted images 1.
It should not be confused with the oreo cookie sign of pericardial effusion 3.
- 1. Tuite MJ, Cirillo RL, De Smet AA, Orwin JF. Superior labrum anterior-posterior (SLAP) tears: evaluation of three MR signs on T2-weighted images. Radiology. 215 (3): 841-5. doi:10.1148/radiology.215.3.r00jn26841 - Pubmed
- 2. Mohana-Borges AV, Chung CB, Resnick D. Superior labral anteroposterior tear: classification and diagnosis on MRI and MR arthrography. AJR. American journal of roentgenology. 181 (6): 1449-62. doi:10.2214/ajr.181.6.1811449 - Pubmed
- 3. Weissman NJ, Adelmann GA. Cardiac imaging secrets. Elsevier Health Sciences. (2004) ISBN:1560535156. Read it at Google Books - Find it at Amazon