MRI Findings in Scapular Pain May Overlap With Age-Related Changes: Study
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MRI findings in patients with scapular pain often overlap with changes seen in the general aging population, according to a study published October 16 in Interventional Pain Medicine. Researchers led by Chetan Potu, MD, of Stanford University, identified C5–C6 cervical spine pathology and supraspinatus tendinopathy as the most prevalent imaging findings, highlighting the need for careful clinical correlation when interpreting MRI results.
To determine the prevalence and characteristics of MRI findings within this population, a 10-year exploratory cross-sectional study of adults who sought care due to scapular pain in an outpatient orthopedic clinic network (Stanford Healthcare) from June 1, 2015, to June 1, 2025, was performed. Among 503 individual cases identified using electronic health record search terms, 284 individuals (56%) underwent at least one MRI of the cervical spine, thoracic spine, shoulder, or scapula.
Board-certified radiologist reports were collected and coded according to pathology of specific anatomic structures, spinal level, and side by physical medicine and rehabilitation physicians. Chi-square test, one-way ANOVA, Fisher's exact test, and two-sample t-test were used for statistical comparison of demographic factors and imaging yield across age groups.
Key findings:
- A detailed review among the 284 scanned patients (age average 51±17 years, 53% women) revealed distinct patterns of anatomical pathology.
- Out of 503 patients with scapula pain, 284 (56%) had their MRI performed: 203 (40%) had cervical spine MRI, 106 (21%) – shoulder MRI, 76 (15%) – thoracic spine MRI, and only 22 (4%) had scapula MRI.
- The median delay until the first MRI was 8 months (IQR 1–31 months).
- In terms of pathology prevalence on MRI, 93 out of 106 shoulder MRIs (88%) revealed supraspinatus tendinopathy, 128 out of 203 cervical MRIs (66%) – C5-6 neural foraminal stenosis, and 79 out of 122 mentioned cervical MRI levels (65%) – C5-6 degenerative changes.
- There were no instances of scapulothoracic bursitis on scapula MRIs (0 out of 22); the range for thoracic degenerative changes on MRI in levels T1-T8 was 0% to 7%.
- The prevalence of supraspinatus tendinopathy, C5-6 stenosis, and C5-6 degeneration was found to increase significantly with aging per decade (p<0.01), and pain laterality did not correlate with spinal MRI findings.
In summary, 10-year observation data demonstrate the high prevalence of degenerative changes of the C5-6, C5-6 neural foraminal stenosis, and supraspinatus tendinopathy on MRI scans of patients with scapular pain. The main points of the study show that since these degenerative signs become more frequent with age, MRI interpretation should be done in relation to the clinical picture of the patient.
Reference:
Potu, C. K., Wong, H. J., Levin, J., & Chou, R. (2026). Prevalence of MRI findings in adults with scapular pain: An exploratory cross-sectional study. Interventional Pain Medicine, 5(4), 100827. https://doi.org/10.1016/j.inpm.2026.100827
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