The double Oreo cookie sign refers to the presence of two hyperintense lines in the superior glenoid labrum, one of which represents a superior labral tear and the other a physiological sublabral recess 1, 2.
This pattern is likened to an 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 is 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