A new study in JAMA Internal Medicine reveals that 99 percent of adults over 40 show at least one rotator cuff abnormality on MRI scans, even when they have no shoulder pain. The Finnish research team examined 602 participants aged 41 to 76, finding that 595 people had rotator cuff abnormalities despite 82 percent reporting no symptoms.

Common findings included partial-thickness tears in 62 percent of participants, tendinopathy in 25 percent, and full-thickness tears in 11 percent. These structural changes increased with age but showed no significant difference between those with and without shoulder pain. The study suggests that many MRI-detected abnormalities may represent normal age-related changes rather than actual pathology requiring treatment.

Researchers argue that the findings challenge the routine use of MRIs for diagnosing shoulder pain and call for a shift in how these findings are communicated to patients. They recommend moving away from terms like "tear" that imply damage requiring repair, suggesting instead language like "lesion" or "structural alteration." Two UCSF orthopedic surgeons in an accompanying editorial agree, warning that current MRI practices may be driving unnecessary interventions and overtreatment of normal anatomical variations.