Rotator-cuff changes in asymptomatic adults. The effect of age, hand dominance and gender

TLDR

The diagnostic criteria for rotator‑cuff lesions were validated on unembalmed cadaver specimens. The study examined rotator‑cuff integrity in 90 asymptomatic adults aged 30–99 using ultrasound of both dominant and non‑dominant shoulders. Rotator‑cuff lesions increase markedly after age 50, affecting over half of individuals in their 70s and 80% of those over 80, yet they are often asymptomatic and show no difference between dominant and non‑dominant arms or genders, so treatment should rely on clinical findings rather than imaging.

Abstract

We studied the integrity of the rotator cuff in both dominant and non-dominant shoulders of 90 asymptomatic adults between the ages of 30 and 99 years using ultrasound. The criteria for diagnosis had been validated on unembalmed cadaver specimens. We found no statistically significant difference in the incidence of impingement findings between dominant and non-dominant arms or between genders. The prevalence of partial- or full-thickness tears increased markedly after 50 years of age: these were present in over 50% of dominant shoulders in the seventh decade and in 80% of subjects over 80 years of age. Our results indicate that rotator-cuff lesions are a natural correlate of ageing, and are often present with no clinical symptoms. Treatment should be based on clinical findings and not on the results of imaging.