2025 ISAKOS Biennial Congress ePoster
Imaging Abnormalities Of The Labrum and Glenohumeral Joint Are Common Findings In Asymptomatic Adult Shoulders: A Systematic Review.
Thomas Ibounig, MD, Helsinki FINLAND
Lasse Rämö, MD, PhD, Helsinki FINLAND
Teppo Jarvinen, MD, PhD, Tampere FINLAND
Romi Haas, MD, PhD,, Melbourne AUSTRALIA
Sean Docking, Md, PhD,, Melbourne AUSTRALIA
Sharon Sanders, MD, PhD, Robina AUSTRALIA
Rachelle Buchbinder, MD, PhD, Prof., Melbourne AUSTRALIA
Helsinki University Hospital, Helsinki, FINLAND
FDA Status Not Applicable
Summary
Structural changes were frequently observed in asymptomatic shoulders in both athletes and other study populations. Athlete populations tended to be younger and/or had higher prevalence rates compared to non-athletes of the same age. The prevalence of labral and glenohumeral joint abnormalities was nearly as high in asymptomatic shoulders as in symptomatic shoulders.
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Abstract
Objective
The primary objective was to determine the population prevalence of labral and glenohumeral joint imaging abnormalities in asymptomatic adults. Secondary objectives included comparing a) the prevalence between athletes and non-athletes, and b) the prevalence of imaging abnormalities in adults with and without symptoms from the same or comparable study populations.
Method
We systematically reviewed studies reporting the prevalence of X-ray, ultrasound (US), computed tomography, and magnetic resonance imaging (MRI) abnormalities in adults without shoulder symptoms (PROSPERO registration number CRD42018090041). This report presents the glenohumeral joint imaging findings. We searched Ovid MEDLINE, Embase, CINAHL and Web of Science from inception to June 2023 and assessed risk of bias using a tool designed for prevalence studies. The primary analysis was planned for the general population. The certainty of evidence was assessed using a modified Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) for prognostic studies.
Results
Thirty-five studies (4 X-ray, 10 US, 20 MRI, 1 X-ray and MRI) reported useable prevalence data. Two studies were population-based (846 shoulders), 15 studies included miscellaneous study populations (1715 shoulders) and 18 included athletes (727 shoulders). All were judged to be at high risk of bias. Clinical diversity precluded pooling. Population prevalence of glenohumeral osteoarthritis ranged from 15% to 75% (2 studies, 846 shoulders, 1 X-ray, 1 X-ray and MRI; low certainty evidence). Prevalence of labral abnormalities, humeral head cysts and long head of biceps tendon abnormalities were 20%, 5%, 30% respectively (1 study, 20 shoulders, X-ray and MRI; very low certainty evidence).
Conclusion
The population-based prevalence of labral and glenohumeral joint imaging abnormalities in asymptomatic individuals remains uncertain, but structural changes were frequently observed in asymptomatic shoulders in both athletes and other study populations. Although there was a large variation in prevalence rates, the overall trend showed that athlete populations were either younger and/or had higher prevalence rates than non-athlete populations of the same age. The prevalence of labral and glenohumeral joint abnormalities was nearly as high in asymptomatic shoulders as in symptomatic shoulders.