JAMA Network JAMA Internal Medicine : Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging
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Feb 16, 2026 Brian T. Feeley, MD, a UCSF shoulder surgeon and sports medicine researcher, and Thomas Ibounig, MD, a Finnish shoulder surgeon and researcher, discuss MRI shoulder findings. They cover the high prevalence of incidental rotator cuff abnormalities, age-related rise in full-thickness tears, risks of overdiagnosis from alarming MRI language, and when MRI should be ordered for clear clinical questions.
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Imaging Abnormalities Are Common With Age
- In adults over 40, MRI shoulder abnormalities are nearly universal, appearing in 99% of participants.
- Many findings are minor in younger people but worsen with age, increasing prevalence of structural tears.
Full-Thickness Tears Often Asymptomatic
- Full-thickness rotator cuff tears rise with age and can be asymptomatic.
- By age 70+, over 20% had full-thickness tears, yet most did not know.
Reword Reports To Reduce Patient Alarm
- Translate MRI language for patients and avoid alarmist phrasing that can cause panic.
- Explain that many degenerative findings are age-related and not necessarily harmful.