Sher and colleagues measured how often MRI shows a rotator cuff tear in asymptomatic shoulders, and how that rate changes with age and activity.
Dominant shoulders of 96 screened volunteers aged 19 to 88, read blind by two radiologists with 20 arthroscopy‑verified shoulders mixed in as controls.
Key Findings
Overall, 33 of 96 asymptomatic shoulders (34%) had a cuff tear on MRI: 14 full‑thickness (15%) and 19 partial‑thickness (20%).
Both full‑thickness (p < 0.001) and partial‑thickness tears (p < 0.05) became more frequent with age.
Among 25 people aged 40 to 60, 1 had a full‑thickness and 6 a partial‑thickness tear. Among 25 aged 19 to 39, none had a full‑thickness tear and 1 had a partial tear.
Of the 14 full‑thickness tears, 13 were in people over 60 and 13 came with acromioclavicular arthrosis. Nine had subacromial spurs.
Over 60, full‑thickness tears were seen in 10 of 28 sedentary and 3 of 18 active people, a difference that was not significant (p = 0.16).
Both radiologists read all 20 arthroscopy‑verified control shoulders correctly: 6 full‑thickness tears, 5 partial tears and 9 intact cuffs.
Board pearl
Over age 60, 54% of asymptomatic shoulders had a rotator cuff tear on MRI, 28% full‑thickness. Under 40, none had a full‑thickness tear.
Authors' conclusion
The results of the present study emphasize the potential hazards of the use of magnetic resonance imaging scans alone as a basis for the determination of operative intervention in the absence of associated clinical findings.
Sher and colleagues measured how often MRI shows a rotator cuff tear in asymptomatic shoulders, and how that rate changes with age and activity.
Dominant shoulders of 96 screened volunteers aged 19 to 88, read blind by two radiologists with 20 arthroscopy‑verified shoulders mixed in as controls.
Key Findings
Overall, 33 of 96 asymptomatic shoulders (34%) had a cuff tear on MRI: 14 full‑thickness (15%) and 19 partial‑thickness (20%).
Both full‑thickness (p < 0.001) and partial‑thickness tears (p < 0.05) became more frequent with age.
Among 25 people aged 40 to 60, 1 had a full‑thickness and 6 a partial‑thickness tear. Among 25 aged 19 to 39, none had a full‑thickness tear and 1 had a partial tear.
Of the 14 full‑thickness tears, 13 were in people over 60 and 13 came with acromioclavicular arthrosis. Nine had subacromial spurs.
Over 60, full‑thickness tears were seen in 10 of 28 sedentary and 3 of 18 active people, a difference that was not significant (p = 0.16).
Both radiologists read all 20 arthroscopy‑verified control shoulders correctly: 6 full‑thickness tears, 5 partial tears and 9 intact cuffs.
Board pearl
Over age 60, 54% of asymptomatic shoulders had a rotator cuff tear on MRI, 28% full‑thickness. Under 40, none had a full‑thickness tear.
Authors' conclusion
The results of the present study emphasize the potential hazards of the use of magnetic resonance imaging scans alone as a basis for the determination of operative intervention in the absence of associated clinical findings.