Double Oreo cookie sign (glenoid labrum)

Last revised by Dr Henry Knipe on 30 Dec 2021

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 sign should not be confused with the Oreo cookie sign of pericardial effusion 3.

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 for a SLAP tear, it is only present in ~20% of patients with a SLAP tear types 2-4 and therefore seems to add little to the sensitivity for SLAP tears on T2-weighted images 1.

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Cases and figures

  • Figure 1: photograph - Oreo cookies
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  • Case 1
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