Technology has made our lives easier in countless ways. We can stream our favorite TV episode with the touch of a button, we can make a cross country road trip with ease, and we can learn intricate details about our health thanks to advanced diagnostics tests. However, we should be careful about becoming overreliant on technology, because it can’t always tell the full story. In today’s blog, we explain why your shoulder diagnosis should always involve a physical exam alongside any imaging tests.
Shoulder Damage Common On Imaging Exams
Shoulder pain is one of the most common reasons that people seek out a professional consultation for musculoskeletal pain, as the condition affects roughly 25 percent of the population each month. Moreover, about 85 percent of these cases are due to pain or discomfort with the rotator cuff – the group of four muscles and tendons that help secure the ball of the shoulder joint within the socket. If you present to the doctor with shoulder pain, there’s a good chance that they’ll first focus on your rotator cuff.
However, problems can develop if an in-depth physical examination is skipped and imaging tests are ordered. That’s because a Finnish study recently found that 99% of participants over the age of 40 showed some form of rotator cuff abnormality on imaging, regardless of whether or not they were experiencing shoulder discomfort at the time of the study. The results indicate that many MRI results simply reflect normal age-related changes in the rotator cuff rather than the actual source of pain, meaning that if providers become overreliant on imaging for diagnostics, they may not hone in on the actual underlying issue.
Researchers concluded that rotator cuff abnormalities on an MRI may just be signs of normal aging, like graying hair, rather than a clear indicator of what’s wrong. They believe the study highlights the need for better ways to determine the difference between rotator cuff changes that actually matter and those that are incidental findings.
“Given that tendinopathy, [partial thickness tears], and even [full thickness tears] may be incidental findings, clinicians should consider their high population prevalence when interpreting imaging results and deciding on interventions targeting these abnormalities. Reframing many of these findings as normal age-related changes rather than disease may help guide more appropriate care and reduce unnecessary interventions,” researchers wrote.
A physical exam isn’t going to provide a world of new information that isn’t seen on an imaging test, but it can add some checks and balances to the diagnostics process. Talking with the patient, learning about their symptoms and watching them perform certain movement tests can give doctors a truer understanding of what the patient is experiencing than a simple image on a computer screen. If their symptoms and their movement restrictions suggest one thing, but the imaging shows rotator cuff abnormalities, perhaps the truth isn’t rooted somewhere else, like with an inflamed tissue or pinched nerve. Rotator cuff damage and degeneration is very common as we get older, so it can’t just be assumed that it is always the source of shoulder discomfort.
At the end of the day, it’s wise to connect with a shoulder specialist who will take the time to really examine your shoulder and talk with you about your capabilities and limitations. You are so much more than numbers or images on a screen, and we want to find the right diagnosis and treatment plan for your unique needs. For more information about common shoulder injuries, or to connect with a physician for a diagnosis, reach out to Dr. Holloway and his team today at (865) 410-7887.
