\nthe general ageing population, according to research published on October 16, 2026 in
\nInterventional Pain Medicine<\/em>. A team led by Chetan Potu, of Stanford University in
\nCalifornia, identified C5-6 pathology and supraspinatus tendinopathy as the most prevalent imaging
\nfindings \u2014 precisely the two that the literature already links to age.<\/p>\n
The authors’ conclusion is a warning about interpretation, not a dismissal of the exam: Pain in the scapular region can arise from several sources: the cervical nerve root, the In practice, clinical history and physical examination drive most decisions, and MRI is called on The study included 503 patients seen at a single centre between 2015 and 2025 who presented to Because the total exceeds the number of patients, some of them had more than one exam. The The most frequent findings were supraspinatus tendinopathy (88%), C5-6 foraminal stenosis (66%) At the other end, the least common findings were scapulothoracic bursitis (0%) and thoracic spine Together, that draws the problem clearly. A finding present in 88% of a population selected for For the radiologist, the lesson concerns wording. Describing supraspinatus tendinopathy or C5-6 For whoever organises the workflow, 284 exams across 503 patients, with multiple regions ordered, The design is retrospective, single-centre, and spans a decade over which MRI protocols and The researchers themselves call for prospective studies with standardised ordering and
\n“Incidental MRI findings in the spine and shoulder increase with age, and therefore MRI findings in
\npatients with scapular pain should be cautiously interpreted within appropriate clinical
\ncontext.”<\/p>\n![\"Horizontal](\"https:\/\/rtmedical.com.br\/wp-content\/uploads\/2026\/10\/scapular-pain-mri-findings-prevalence.png\")
Why scapular pain is a hard imaging problem<\/h2>\n
\nglenohumeral joint, the rotator cuff, the scapulothoracic articulation, periscapular musculature,
\nthe thoracic spine or referred visceral pain. Correctly identifying the source matters because it
\ndetermines the interventional strategy \u2014 a nerve root block, a subacromial injection, a facet block
\nor a muscular approach are distinct procedures with distinct targets.<\/p>\n
\nwhen isolated scapular pain fails to improve over time. What was missing, the authors note, was data
\non when clinicians decide to order MRI, which region they order and which abnormalities appear most
\noften. The study was designed to fill that gap.<\/p>\nDesign and numbers<\/h2>\n
\northopaedic clinics with scapular pain. Of those, 284 underwent at least one MRI exam. The
\ndistribution by region reveals the ordering pattern: cervical spine in 203 cases, shoulder in 106,
\nthoracic spine in 76 and the scapula itself in only 22.<\/p>\n
\nauthors state the hypothesis honestly: “While the reason for additional imaging was not assessed in
\nthe present study, it is possible that the imaging findings from the first MRI did not sufficiently
\nexplain the etiology of the scapular pain, or that treatment of that anatomic region did not improve
\nthe scapular pain.” In other words, the second exam tends to follow a first one that failed to
\nanswer the clinical question.<\/p>\nFinding prevalence and the specificity problem<\/h2>\n
\nand C5-6 degenerative changes (65%). All showed significant associations with age (p < 0.01 for
\nall) but not with sex \u2014 a result that reinforces earlier studies on the rising prevalence of
\nsupraspinatus tendinopathy and rotator cuff disease over a lifetime.<\/p>\n
\ndegenerative changes (0% to 7%). Notably, the team observed no association between the laterality of
\nthe scapular pain and the laterality of cervicothoracic spine findings: pain on one side did not
\npredict a finding on the same side.<\/p>\n
\npain, strongly age-dependent and uncorrelated with the symptomatic side, has low specificity for
\nexplaining the complaint. It can be present and still be irrelevant.<\/p>\nPractical implications for reporting and referral<\/h2>\n
\nforaminal stenosis without qualifying how prevalent those changes are in the patient’s age group
\nhands the clinician a datum that looks explanatory and often is not. A report that records the
\nfinding and adds that it is common in asymptomatic people of the same age is more useful \u2014 and
\nreduces the chance that the exam becomes justification for a procedure aimed at the wrong
\ntarget.<\/p>\n
\npoints to potential waste. It is worth assessing whether a clearer indication protocol would reduce
\nthe chaining of exams \u2014 the same efficiency discussion we raised when covering
\nthe cost of MRI repeats<\/a>.
\nAnd the theme connects directly to the broader debate about
\nhow to handle incidental findings<\/a>,
\nwhere the presence of an abnormality is not the same as causation.<\/p>\nLimitations and what comes next<\/h2>\n
\nreporting criteria changed. There was no control group of patients without scapular pain undergoing
\nthe same exams, which would be the direct test of the overlap hypothesis; the authors rely on
\ncomparison with the literature. Outcomes were not assessed either: it is unknown whether patients
\nwho had MRI fared better.<\/p>\n
\ninterpretation, able to determine the clinical utility of imaging in this setting. It is the kind of
\nquestion musculoskeletal radiology has been facing in other joints \u2014 including with quantitative
\ntools, as we covered in
\nradiomics for grading osteoarthritis<\/a>
\n\u2014 and one that will only grow in relevance as imaging becomes more accessible and the risk of
\nincidental findings rises in step.<\/p>\n