 I want to talk about some weird idiosyncrasies of slap lesions. Dr. P here, and we've got our pear-shaped glenoid cup in blue with a little bare area here in the center. Here's our bare area. And here are some key structures anteriorly, the superior and middle glenohumor ligament. The middle glenohumor ligament being the most variable, the superior glenohumor ligament being the smallest. And the largest and most consistent GHL is the IGHL with its anterior band, axillary band and posterior band. Now first, the quadrant, you know, a slap lesion, slap stands for superior labrum anterior to posterior. But sometimes, you get a lesion that starts here, it's not truly superior, more posterior superior, and it works its way around the back. Now, it's not so important that you know the designation right now, which is a slap 8, but just that, it's not truly a superior isolated superior labral phenomenon. It's more of a posterior rim phenomenon, yet this still gets the moniker slap 8. So there's going to be a fair amount of variability with regard to quadrant. Second, you're going to have lesions that collide with one another. For instance, you have a superior labral tear that's kind of chronic, and then you dislocate and develop a big, banker lesion here, maybe even with some bone involvement, and then this one propagates up this way, and this one propagates down that way, and eventually they collide and meet each other. And that ends up being a slap 5. So collision lesions can occur in conjunction with chronic slap lesions. The next thing I want to cover is the biceps. We talked about the importance of understanding how a slap lesion relates to the base of the biceps anchor. Clinicians want to know if it's in front, underneath, or behind. But one other highlight I want to make for you is that the biceps has a highly variable origin. So sometimes it comes off back here. Sometimes the biceps comes off over here. And sometimes it even comes off in the front, conjoint with some of these other ligaments. So that can be awfully weird and a little bit difficult to analyze if you're not used to this variability. The next thing I want to mention are cysts. Now the presence of a cyst, slam dunk automatically makes the diagnosis of a slap lesion. You don't get ganglion pseudo cysts typically around the shoulder. If you see a cyst, even if you don't see a slap lesion, the odds are it's a chronic slap lesion that is sealed over and has a ball valve phenomenon and simply scarred. Now a lot of the cysts that you're going to see are going to be posterior superior. They're going to spill over the spinal glenoid rim into the super scapula. Not you're going to see them here. But sometimes they'll behave rather weirdly. So the ones in the front, they can dissect right around or under the SGHL. I've seen them dissect into the SGHL. I've seen them dissect into the capsule and into the MGHL. And then there's the very strange upside down lesion that's not from a dislocation. It's the same as a slap 2 down here with paralabal cysts. And although I made this up, I call these the upside down slap lesion. And if I have it without a cyst, I call it a slap 11. If I have a widest cyst, I call it a slap 12, even though it's down low. So that's something I made up just to help you understand and relate to this class of lesions that are more often chronic than acute, although they can occur from acute trauma. Let's move on, shall we?