Double Oreo cookie sign (glenoid labrum)
Citation, DOI & article data
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.
- 1. Tuite M, Cirillo R, De Smet A, Orwin J. Superior Labrum Anterior-Posterior (SLAP) Tears: Evaluation of Three MR Signs on T2-Weighted Images. Radiology. 2000;215(3):841-5. doi:10.1148/radiology.215.3.r00jn26841 - Pubmed
- 2. Mohana-Borges A, Chung C, Resnick D. Superior Labral Anteroposterior Tear: Classification and Diagnosis on MRI and MR Arthrography. AJR Am J Roentgenol. 2003;181(6):1449-62. doi:10.2214/ajr.181.6.1811449 - Pubmed
- 3. Neil J. Weissman, Gabriel A Adelmann, MD. Cardiac Imaging Secrets. (2004) ISBN: 9781560535157 - Google Books