Unilateral shoulder pain and bilateral MRI findings

Magnetic resonance imaging (MRI) is commonly used to diagnose structural abnormalities in the shoulder. However, clinical findings may not be the source of symptoms (article).

In this study was evaluated over 100 individuals who reported unilateral shoulder pain, with no signs of adhesive capsulitis, no substantial range-of-motion deficit, no history of upper-limb fractures, no repeated shoulder dislocations, and no neck-related pain. All partecipants had MRI (interpreted by an orthopedic shoulder surgeon and a musculoskeletal radiologist) of both symptomatic and asymptomatic shoulders.

Results: Abnormal MRI findings were observed in both shoulders.

Rotator cuff tendinopathy, partial-thickness tear, full-thickness tear, labrum alterations, acromial morphology (Type I, II, III), long head of biceps alterations, AC joint alterations, subacromial fluid, fatty infiltration, glenohumeral osteoarthritis.

Only the frequencies of full-thickness supraspinatus tendon tears and glonohumeral osteoarthritis (OA) were higher (about 10%) in the symptomatic shoulder according to the surgeon’s findings only.

Agreement between the musculoskeletal radiologist and shoulder surgeon ranged from slight to moderate.

Conclusion

Most abnormal MRI findings were not different in frequency between symptomatic and asymptomatic shoulders.

Consider additional factors to help explain patients pain (Todd Hargrove).