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.

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Article information

rID: 52650
Section: Signs
Synonyms or Alternate Spellings:
  • oreo cookie sign

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Cases and figures

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    Figure 1: photograph - oreo cookies
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