Pain related to rotator cuff abnormalities: MRI findings without clinical significance

MRI has become an important diagnostic tool in the evaluation of rotator cuff pathology and the technology continues to evolve. Direct MR arthrography, diagnosis-specific sequencing such as fat suppression, special positioning such as abducted externally rotated (ABER) views and ultra high field magnets allow for an unprecedented level of detail in imaging. In this article, we review MRI findings in patients with rotator cuff abnormalities that are anatomic variants or incidental findings. Although MRI findings may be diagnostic in some cases, we find that clinical correlation with history and physical examination is critical to differentiate between anatomic variants, incidental findings, and true pathology. We conclude that good communication between the orthopedic surgeon and the radiologist is necessary to optimize diagnostic yield.