Skip to main content
AAPM&R Events Main banner
JFK Johnson
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
In-Person
In-Person
On Demand
On Demand
Live Stream
Live Stream
Invite Only
Invite Only
Ticketed
Ticketed
Coffee Break
Coffee Break
Meal
Meal
Reception
Reception
Back

Musculoskeletal and Sports Medicine

(Research Hub Theater) Shoulder Pathology on Advanced Imaging in Asymptomatic Athletes: A Systematic Review

Thursday, November 16, 2023
12:45 PM – 2:15 PM CT

    Primary Author(s)

  • Connie M. Hsu, MD (she/her/hers)

    Resident Physician
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Cambridge, Massachusetts

    • Co-Author(s)

  • Sean Schowalter, MD

    Resident Physician
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

  • KV

    Kevin Vu, MD

    Resident Physician
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

  • Toqa Afifi, MD (she/her/hers)

    Resident Physician
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Cambridge, Massachusetts

  • Bryan Le, MD

    Resident Physician
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

  • Joanne Borg-Stein, MD

    Attending Physician
    Spaulding Rehabilitation Hospital
    Charlestown, Massachusetts

Background and/or Objectives: The objective of this study is to conduct a systematic review with meta-analysis to evaluate the prevalence of shoulder pathologies seen on MRI in asymptomatic athletes.

Design: Systematic Review and Meta-Analysis

Setting: N/A

Participants: 19 studies with a total of 569 shoulders were included in the study.

Interventions: MRIs of asymptomatic shoulders of athletes were evaluated for shoulder pathology.

Main Outcome Measures: The primary outcome of the study was the prevalence of shoulder pathology (rotator cuff, biceps, subacromial bursa, labrum, AC joint, humerus) on MRI. Variables investigated include age, level of sport, and participation in overhead sport.

Results: The overall pooled prevalence estimate of shoulder pathology is as listed: rotator cuff 52.6% (CI 50.0% to 55.2%), biceps tendon 28.0% (CI 24.1% to 31.9%), subacromial 55.7% (CI 52.9% to 58.5%), labral 42.4% (CI 39.8% to 45.0%), AC joint 29.9% (CI 27.5% to 32.2%), and humeral head 49.3% (CI 47.3% to 51.4%). From our preliminary correlation analysis, overhead sports, higher level of play, and increased age was significantly associated with higher prevalence of shoulder pathology. From our meta-regression analysis, participation in overhead sport was a strong predictor for rotator cuff pathology (R2 = .771, p<.001), biceps tendon pathology (R2 = .889, p<.001), subacromial pathology (R2 = .599, p<.001), labral pathology (R2 = .555, p < .001), AC joint pathology (R2 = .434, p < .001), and humeral pathology (R2 = .526, p < .001).

Conclusions: Pooled summary estimates of the prevalence of shoulder pathology on MRI in asymptomatic athletes ranged from 25.7% to 67.7%, with significantly higher prevalence seen in higher level athletes, advanced age, and overhead sports. This confirms the hypothesis that there is a high prevalence of asymptomatic shoulder pathology in athletes likely related to wear and tear on the shoulder. Further studies may be required to elucidate the significance of these findings.