Magnetic resonance imaging of the asymptomatic shoulder of overhead athletes: a 5-year follow-up study.
BACKGROUND
Although several studies have described magnetic resonance imaging findings in shoulders of asymptomatic volunteers, no such investigation has been performed on asymptomatic dominant and nondominant shoulders of elite overhead athletes.


OBJECTIVE
Asymptomatic dominant shoulders of elite overhead athletes may have a higher incidence of magnetic resonance imaging abnormalities than either their nondominant shoulder or shoulders of asymptomatic volunteers.


METHODS
Prospective cohort study.


METHODS
Detailed magnetic resonance imaging scans of asymptomatic dominant and nondominant shoulders of elite overhead athletes were obtained. Three experienced musculoskeletal radiologists interpreted each scan for multiple variables, including rotator cuff appearance. Images from a surgical control group were intermixed to assess accuracy and control for observer bias. A 5-year follow-up interview was performed to determine whether magnetic resonance imaging abnormalities found in the initial stage of the study represented truly clinical false-positive findings or symptomatic shoulders in evolution.


RESULTS
Eight of 20 (40%) dominant shoulders had findings consistent with partial- or full-thickness tears of the rotator cuff as compared with none (0%) of the nondominant shoulders. Five of 20 (25%) dominant shoulders had magnetic resonance imaging evidence of Bennett's lesions compared with none (0%) of the nondominant shoulders. None of the athletes interviewed 5 years later had any subjective symptoms or had required any evaluation or treatment for shoulder-related problems during the study period.


CONCLUSIONS
Magnetic resonance imaging alone should not be used as a basis for operative intervention in this patient population.
Connor
Patrick M
PM
Miller Orthopaedic Clinic, Charlotte, North Carolina, USA.
Banks
David M
DM
Tyson
Alan B
AB
Coumas
James S
JS
D'Alessandro
Donald F
DF
D000328:Adult; D001265:Athletic Injuries / Q000175:diagnosis*; D001484:Baseball / Q000293:injuries; D001696:Biomechanical Phenomena; D015331:Cohort Studies; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015588:Observer Variation; D012016:Reference Values; D017006:Rotator Cuff / Q000473:pathology*; D000070636:Rotator Cuff Injuries; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000033:anatomy & histology* / Q000473:pathology*; D013715:Tennis / Q000293:injuries