A recent study analyzing 1,204 shoulders found that 90% of adults over 40 exhibit shoulder "abnormalities" on MRI scans, a finding that holds true for both symptomatic and asymptomatic individuals. Notably, 96% of asymptomatic shoulders displayed these "abnormalities," alongside 98% of symptomatic ones. Researchers observed no significant difference in the prevalence of tendinopathy, partial-thickness tears, or even full-thickness tears between the groups when accounting for other MRI findings.
These results suggest clinicians should re-evaluate how MRI findings are interpreted and communicated to patients. The authors advocate for a shift away from terms like "abnormality" or "tear," which can incite anxiety and a perceived need for intervention. Instead, they propose using more neutral language such as "lesion," "defect," "fraying," "disruption," "structural alteration," or "degeneration" to better reflect age-related changes rather than immediate clinical issues.
Experts concur, emphasizing that MRI results should not be the sole basis for treatment decisions. They recommend prioritizing patient history, clinical examination, and functional limitations. For non-injury related shoulder pain, a period of watchful waiting, rest, or physical therapy should precede imaging. If symptoms persist without meaningful improvement, an MRI may then be considered, but treatment should always be guided by the patient's overall condition.