18/02/2026
Interesting read, credits to the original owner: shoulder_physio!
Alam mo ba na tao over the age of 40 years old, ay may problema sa kanilang balikat?
Sa bagong pag-aaral na lumabas sa JAMA Internal Medicine:
👉 99% ng mga taong lampas 40 years old ay may nakikitang “abnormality” sa rotator cuff sa MRI.
👉 78% ng full tears ay nakita sa mga balikat na WALANG nararamdamang sintomas.
Kahit pagsamahin pa ang advanced MRI at exam ng experienced surgeon, hindi pa rin nila maaasahang matukoy kung alin ang masakit at alin ang hindi, base sa imaging lang.
Ano ang ibig sabihin nito?
Pag lampas 40 na tayo, karamihan sa nakikita sa MRI ng rotator cuff ay maaaring:
➡️ normal na pagbabago dahil sa edad
➡️ parang pagputi ng buhok
➡️ parang pagkakaroon ng wrinkles
➡️ parang butas ng medyas, hindi automatic na emergency! 😄
Dahil dito, iminumungkahi ng mga authors na baguhin ang lenggwahe:
❌ Imbes na “tear” agad (na parang may napunit at kailangang ayusin)
✅ Mas tamang tawagin minsan na “age-related structural change”
Key takeaway:
Kapag halos lahat ay may nakikitang “finding” sa MRI,
👉 hindi na ito sapat na basehan para sabihing iyon ang sanhi ng sakit.
Taken from
99% of people over 40 have a rotator cuff ‘abnormality’ on MRI.
Do we round up to, everyone?
The FIMAGE study just dropped in JAMA Internal Medicine and it’s important for several reasons.
Here’s a quick overview of the study:
→ 602 people randomly selected from the Finnish general population (not a clinic sample)
→ Aged 41–76
→ Bilateral 3T MRI of both shoulders
→ Blinded reads by experienced musculoskeletal radiologists
→ Standardised clinical exams by shoulder surgeons with 10+ years experience
They found:
→ 98.7% had at least one RC abnormality
→ 7 out of 602 had completely normal tendons
→ 62% had partial-thickness tears
→ 11% had full-thickness tears (rose with age)
→ RC abnormalities were in 96% of pain-free shoulders AND 98% of painful shoulders
78% of all full-thickness tears were found in shoulders with zero symptoms.
Even combining state-of-the-art 3T MRI with experienced surgeon clinical exams could not reliably distinguish a symptomatic shoulder from an asymptomatic one.
The authors argue, and I think the data supports this, that most RC findings after 40 represent normal age-related structural change. Like grey hair. Like wrinkles. Like holes in your socks.
They emphasise a shift in language is warranted: away from ‘tear’ (which implies trauma and repair) toward terms like ‘structural alteration’ or ‘age-related change.’
When the baseline prevalence of an MRI finding approaches 100%, the finding itself has almost no diagnostic value.
How does this change the way you talk to your patients about their MRI results?
