Double Oreo cookie sign (glenoid labrum)

Assoc Prof Craig Hacking and Dr Tim Luijkx et al.

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.

Inspired signs

Article information

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

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Cases and figures

  • Figure 1: photograph - Oreo cookies
    Drag here to reorder.
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