46 Prevalence of asymptomatic shoulder findings on magnetic resonance imaging (MRI): a scoping review

Background Shoulder MRI for diagnostic purposes carries an inherent risk of finding asymptomatic changes not causing problems. This can lead to overdiagnosis and ultimately, overtreatment. To mitigate this risk, it is valuable to know the prevalence of asymptomatic findings. The aim of this study was to investigate the prevalence of asymptomatic shoulder MRI findings.Methods Original studies investigating asymptomatic adolescent and adult participants with shoulder MRI were eligible for inclusion in this scoping review. Medline, Embase, CINAHL and SPORTDiscus were searched from inception to April 2024. Two reviewers independently screened titles and abstracts, and full text versions of articles. One reviewer extracted data. Disagreement was resolved by dialogue.Results 5.177 records were identified. 417 underwent full-text screening, and data were extracted from 28 articles, preliminary data. 1.074 asymptomatic shoulder MRI’s were included. The methodology and prevalence of asymptomatic findings varied considerably across studies and age-groups, multiple studies reporting rotator cuff-related findings higher than 50%. Across all studies and age-groups, mean prevalence of asymptomatic findings were: rotator cuff lesions: 22.3%, labrum lesions: 16.7%, acromioclavicular osteoarthritis: 13.9%, osseous cysts: 9.8%, bursitis: 6.5%, long head of biceps tendon lesions: 4.4%, glenohumeral osteoarthritis: 3.9%, and other findings: 14.1%. Mean age of participants were 49 years.Conclusion Asymptomatic findings on shoulder MRI seem to be common, with rotator cuff-related findings being the most frequent. This emphasizes the importance of clinical decision-making to extend beyond MRI imaging alone.