Rotator Cuff Imaging Abnormalities in Asymptomatic Shoulders: A Systematic Review

Area of Science:

• Orthopedics
• Radiology
• Sports Medicine

Background:

• Rotator cuff (RC) abnormalities are frequently detected via imaging.
• Understanding the prevalence of these abnormalities in asymptomatic individuals is crucial for clinical interpretation.
• Previous research has yielded varied prevalence estimates for RC pathologies in asymptomatic shoulders.

Purpose of the Study:

• To systematically review and estimate the prevalence of rotator cuff (RC) imaging abnormalities in asymptomatic adult shoulders.
• To synthesize data on tendinopathy, partial-thickness tears, full-thickness tears, and calcification detected by various imaging modalities.

Main Methods:

• Systematic review of studies reporting RC abnormalities in asymptomatic shoulders.
• Literature search across major databases (Ovid MEDLINE, Embase, CINAHL, Web of Science) with citation tracking.
• Inclusion of 53 studies (ultrasound and MRI) across population-based, miscellaneous, and athlete cohorts; data synthesized qualitatively due to heterogeneity.

Main Results:

• Prevalence estimates for full-thickness tears ranged from 0% to 35% on ultrasound and 0% to 20% on MRI across different populations.
• Prevalence for tendinopathy and/or partial-thickness tears varied widely, from 0% to 70% on ultrasound and 0% to 100% on MRI.
• The certainty of evidence for all reported prevalence rates was determined to be low to very low.

Conclusions:

• Imaging abnormalities of the rotator cuff (RC) are highly prevalent in asymptomatic shoulders, with reported ranges from 0% to 100%.
• The wide variability and low certainty of evidence underscore the challenges in interpreting imaging findings in asymptomatic individuals.
• Further high-quality research is needed to establish more reliable prevalence data for RC abnormalities in asymptomatic shoulders.