99% of Adults Over 40 Have Shoulder 'Abnormalities' on an MRI, Study Finds
2 27Up to a third of people worldwide have shoulder pain; it's one of the most common musculoskeletal complaints. But medical imaging might not reveal the problem -- in fact, it could even cloud it. From a report: In a study published in JAMA Internal Medicine this week, 99 percent of adults over 40 were found to have at least one abnormality in a rotator cuff on magnetic resonance imaging (MRI). The rotator cuff is the group of muscles and tendons in a shoulder joint that keeps the upper arm bone securely in the shoulder socket -- and is often blamed for pain and other symptoms.
The trouble is, the vast majority of the people in the study had no problems with their shoulders. The finding calls into question the growing use of MRIs to try to diagnose shoulder pain -- and, in turn, the growing problem of overtreatment of rotator cuff (RC) abnormalities, which includes partial- and full-thickness tears as well as signs of tendinopathy (tendon swelling and thickening). "While we cannot dismiss the possibility that some RC tears may contribute to shoulder symptoms, our findings indicate that we are currently unable to distinguish clinically meaningful MRI abnormalities from incidental findings," the study authors concluded.
2 comments
Re:obviously (Score: 5, Insightful)
by alvinrod ( 889928 ) on Tuesday February 17, 2026 @12:19PM (#65994456)
You're missing what the article is about. What you say is true, but it's also claiming that when people without problems are given an MRI the results make it appear as though they do have a problem. If a person did have a problem they'd need an MRI anyway to determine where the problem is and how to fix it. Unless the surgeons are going to replace the entire arm, how would they know what needs to be operated on without the MRI? This only prevents needless surgeries for those who had an MRI for some other reason but had their doctor point out something that looks like a shoulder problem.
This seems like a good start for a longitudinal study. Do these people develop shoulder problems later and the MRI is just catching in very early? Is there some other factor that can predict those who will later have shoulder problems vs. those who won't? This study may not tell us much by itself, but it tells us what questions we ought to be asking to explain the results. The first step is to replicate the results from this study to ensure it wasn't due to some fluke or other factor that wasn't controlled for and from there to develop other studies to help us understand what's happening better. I think that makes it a rather useful study.
Re:obviously (Score: 5, Informative)
by EvilSS ( 557649 ) on Tuesday February 17, 2026 @12:49PM (#65994530)
This was the selection criteria for the study:
In 2022, the Health 2000 database was reviewed to identify all individuals eligible for the FIMAGE study. To be eligible, participants had to meet the following criteria: (1) prior participation in the Health 2000 survey, (2) valid consent for the Health 2000 follow-up, (3) ability to communicate in Finnish or Swedish, (4) ambulatory status, (5) maximum age of 75 years at the time of sampling, and (6) residence within the catchment areas of the 5 university hospitals, ensuring reasonable access to a 3-Tesla (3T) MRI facility.
You will note that "has shoulder problem" is not one of the criteria.
The study population:
A total of 602 participants (median age, 58 [range, 41-76] years) underwent clinical shoulder examination and bilateral shoulder MRI and were included in the study. Of these, 313 (52.0%) were females and 289 (48.0%) were males. At the time of the research visit, 110 participants (18%) reported current shoulder symptoms. Among the asymptomatic group, 294 participants (60%) reported a previous history of shoulder symptoms
So 18% reported current shoulder symptoms, and of those who didn't, 40% reported having no history of shoulder symptoms.