Magnetic Resonance Imaging Evaluation of the Rotator Cuff Tendons in the Asymptomatic Shoulder

Abstract

Thirty shoulders in 20 volunteers (average age, 29 years; range, 17 to 49) with no shoulder symptoms or known abnormalities were scanned using magnetic resonance imaging. All scans were interpreted by one radiologist who was blinded to clinical data. Appearance of rotator cuff tendons on the images was graded. Grade 0 was normal, homogeneous low signal intensity structure. Grade 1 lesion was focal, linear, or diffuse intermediate signal through the tendon. Grade 2 lesion was high signal intensity within the tendon and less than full thickness. Grade 3 was high signal intensity through full thickness of the tendon. No supraspinatus or infraspinatus tendons were grade 0 (normal); all supraspinatus and infraspinatus tendons had grade 1 changes through the tendons; and 7 of 30 (23%) of the tendons had grade 2 changes. None of the 30 shoulders had grade 3 changes in the rotator cuff tendons. There is a wide array of abnormal magnetic resonance imaging signals in shoulders of young asymptomatic individuals, but they do not have full-thickness rotator cuff tears (grade 3 lesion). Nonenhanced magnetic resonance imaging may be of limited value in defining rotator cuff injury in a patient with shoulder pain unless a full-thickness rotator cuff tear is suspected clinically.

Shoulder Strength in Asymptomatic Individuals with Intact Compared with Torn Rotator Cuffs

“…We observed that the prevalence of asymptomatic rotator cuff tears increased with age as has been reported in previous studies [5][6][7][8][9]17 . The prevalence of rotator cuff tears in asymptomatic subjects in this study is slightly lower than that reported by some investigators.…”

“…No imaging modalities were used to exclude asymptomatic rotator cuff tears in these studies. Rotator cuff tears are often asymptomatic in elderly individuals [5][6][7][8][9] . The prevalence of rotator cuff tears has been reported to be as high as 50% in asymptomatic individuals older than sixty years and may increase to 80% in those older than eighty years 5 .…”

RETRACTED: Etiology of rotator cuff tears in paraplegic patients: a case-control study

“…15,24,32 A vast majority of individuals with RCTs present with symptoms. 15,16,19,24,32 Failure of the rotator cuff tendon is the most common clinical problem of the shoulder in the elderly population, accounting for more than 4.5 million physician visits per year in the United States. 13,21 The natural history of degenerative cuff tendon failure is one of age-related progression.…”

Diagnosis of Shoulder Pain by History and Selective Tissue Tension: Agreement Between Assessors

“…8 Ultrasonography is valuable for detecting full thickness tears, but less so for small tears. 8,19,21 Furthermore, asymptomatic tears are common, 16,18 so that lesions correctly diagnosed by imaging modalities are of uncertain significance.…”