Magnetic resonance imaging in the painful shoulder: incidence and characterization of common lesions

Abstract

Painful shoulder is a frequent reason for consultation, with Magnetic Resonance Imaging (MRI) being key for its diagnosis. However, the prevalence and interrelation of these pathologies in our environment are not fully documented. Objectives: to determine the incidence, characteristics, and associations of the most common lesions in patients with painful shoulder evaluated by MRI at the Centro Medico Docente La Trinidad. Methods: an observational, descriptive, cross-sectional study was conducted. We analyzed 257 shoulder MRIs from symptomatic patients during 2024. Patients with previous surgeries, fractures, or tumor-related pathology were excluded. Demographic data and findings related to the rotator cuff, SLAP lesions (superior labrum from anterior to posterior), and biceps tendinopathy were recorded. Results: the sample (N=187) had a mean age of 56.6 years, with a male predominance (55.6%). The most frequent pathologies were acromioclavicular osteoarthritis (52.9%), rotator cuff tears (52.9%), and Superior labral anterior posterior (SLAP) lesions (46.5%). Isolated cuff tendinosis was present in 37.4% and full-thickness tears in 19.3%. Biceps pathology was identified in 37.4%, showing a strong association with full-thickness cuff tears (present in 58.3% of these cases) and with SLAP lesions (present in 55.1% of these cases). Conclusions: painful shoulder in our population presents as a spectrum of interconnected degenerative pathology. Rotator cuff injury is the central axis, frequently associated with acromioclavicular osteoarthritis and biceps tendinopathy. The high incidence of SLAP lesions (Types 1 and 2) on MRI suggests age-related degenerative changes, requiring strict clinical correlation.