Incidental rotator cuff abnormalities on magnetic resonance imaging

Key Points

1. Magnetic Resonance Imaging (MRI) detected rotator cuff abnormalities are present in 98.7% of adults aged 41-76, including 96% of asymptomatic shoulders.

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BACKGROUND & OBJECTIVE

Shoulder pain affects approximately 18-31% of the general population globally each month (1) and ranks as the third most common musculoskeletal complaint presenting to primary care, largely attributed to rotator cuff abnormalities (2). MRI is commonly used in the initial evaluation of shoulder pain despite limited evidence supporting routine imaging in atraumatic cases (3). Current literature suggests poor concordance between rotator cuff related MRI findings and shoulder symptoms (4), but robust population-based data are limited.

The objective of this study was to determine the prevalence of MRI detected rotator cuff abnormalities in a nationally representative Finnish adult population and further evaluate the association between these findings and reported shoulder symptoms.

Shoulder pain affects approximately 18-31% of the general population globally each month and ranks as the third most common musculoskeletal complaint presenting to primary care.

Reframing many of the MRI findings reported as normal age-related changes rather than disease related changes may help with more appropriate care and reduce unnecessary patient anxiety and interventions.

METHODS

This was a population-based cross-sectional study (Finnish Imaging of Shoulder – FIMAGE study) conducted between 2023-2024. A random sample of 602 adults, aged 41-76 were selected from the Finnish population and underwent:

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