{
  "abstract": "Objectives The SystematiC Review of shoUlder imaging abnormaliTies IN asYmptomatic adults (SCRUTINY) study aimed to summarize the prevalence of shoulder imaging abnormalities in asymptomatic adults from population-based studies. Secondary objectives included a) assessing the prevalence in other study populations, such as volunteers, healthcare-populations and athletes, and b) comparing the prevalence of imaging abnormalities in adults with and without symptoms from the same or comparable study populations.Method We conducted a systematic review of studies examining the prevalence of shoulder imaging abnormalities detected by X-ray, ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) in asymptomatic adults (PROSPERO registration number CRD42018090041). This report focuses on imaging abnormalities of the acromioclavicular joint and the subacromial space. We searched Ovid MEDLINE, Embase, CINAHL and Web of Science from inception to June 2023. Our primary analysis was conducted on data from population-based studies, and we assessed the risk of bias and certainty of evidence using tools tailored for prognostic studies.Results Thirty-one studies (4 X-ray, 11 US, 15 MRI, 1 X-ray and MRI) reported useable prevalence data. One study was population-based (20 shoulders), 16 included miscellaneous study populations (2436 shoulders) and 14 included athletes (708 shoulders). The certainty of evidence was very low mainly due to high risk of bias, imprecision, and indirectness of the included studies. Clinical diversity precluded pooling. The population prevalence of acromioclavicular joint abnormalities ranged from 85% based on MRI findings to 95% based on X-ray findings. Prevalence of subacromial bursa abnormalities was reported as 90% (MRI), subacromial space abnormalities as 20% (X-ray), and subacromial calcification as 5% (X-ray).Conclusions The true prevalence of AC joint and SA space imaging abnormalities in asymptomatic individuals remains unclear, although estimates suggest it may be between 90 and 95%. Except for SA calcifications, which seem to be more common in symptomatic shoulders, these abnormalities are almost as frequent in asymptomatic shoulders as in those with symptoms. This suggests that caution is needed when drawing causal connections between imaging results and shoulder symptoms. More accurate prevalence data are essential for developing evidence-based approaches to managing shoulder pain in clinical practice.",
  "authors": [
    {
      "affiliations": [
        "Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland",
        "Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland"
      ],
      "name": "Thomas Ibounig"
    },
    {
      "affiliations": [
        "Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland",
        "Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland"
      ],
      "name": "Lasse Rämö"
    },
    {
      "affiliations": [
        "Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia"
      ],
      "name": "Romi Haas"
    },
    {
      "affiliations": [
        "Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia"
      ],
      "name": "Mark Jones"
    },
    {
      "affiliations": [
        "Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland",
        "Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland"
      ],
      "name": "Teppo Järvinen"
    },
    {
      "affiliations": [
        "Finnish Centre for Evidence-Based Orthopaedics, University of Helsinki, Helsinki, Finland",
        "Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland"
      ],
      "name": "Simo Taimela"
    },
    {
      "affiliations": [
        "Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia"
      ],
      "name": "Sean Docking"
    },
    {
      "affiliations": [
        "Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia"
      ],
      "name": "Sharon Sanders"
    },
    {
      "affiliations": [
        "Musculoskeletal Health and Wiser Health Care Units, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia"
      ],
      "name": "Rachelle Buchbinder"
    }
  ],
  "title": "002 Imaging abnormalities in the acromioclavicular joint and subacromial space are common in asymptomatic shoulders: a systematic review",
  "uid": "0e676729-9ff0-5b40-ba42-0cef360e1d17"
}