{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:34:25Z","timestamp":1792762465287,"version":"4.5.0"},"reference-count":79,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"12","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>OBJECTIVE: To estimate the prevalence of rotator cuff (RC) imaging abnormalities (tendinopathy, partial-thickness tear, full-thickness tear, or calcification) on radiograph, ultrasound, computed tomography, or magnetic resonance imaging (MRI) in asymptomatic adult shoulders.<\/jats:p>\n                  <jats:p>STUDY DESIGN: Systematic review.<\/jats:p>\n                  <jats:p>LITERATURE SEARCH: Ovid MEDLINE, Embase, CINAHL, and Web of Science (searched September 1, 2024), with forward and backward citation searches.<\/jats:p>\n                  <jats:p>STUDY SELECTION CRITERIA: We included studies reporting the prevalence of RC abnormalities on imaging of asymptomatic shoulders.<\/jats:p>\n                  <jats:p>DATA SYNTHESIS: Due to heterogeneity, data were synthesized without meta-analysis. Risk of bias was assessed using a tool for prevalence studies. Certainty of evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.<\/jats:p>\n                  <jats:p>RESULTS: After screening 3801 records and 188 studies in full text, we included 53 studies (29 ultrasound, 24 MRI) across population-based, miscellaneous, and athlete populations. The certainty of evidence was low to very low. For full-thickness tears, prevalence on ultrasound was 11% to 17% in 2 population-based samples (1631 shoulders), 0% to 35% across 14 studies of miscellaneous populations (3390 shoulders), and 0% to 22% across 4 studies of athlete populations (346 shoulders). On MRI, the prevalence was 20% in 1 population-based study (20 shoulders), 0% to 14% across 10 studies of miscellaneous populations (490 shoulders), and 0% to 11% across 12 studies of athlete populations (326 shoulders). For tendinopathy and\/or partial-thickness tears, the prevalence on ultrasound was 34% in 1 population-based sample (539 shoulders), 0% to 47% across 11 studies of miscellaneous populations (1971 shoulders), and 7% to 70% across 4 studies of athlete populations (346 shoulders). On MRI, the prevalence was 65% in 1 population-based sample (20 shoulders), 0% to 100% across 10 studies of miscellaneous populations (490 shoulders), and 6% to 96% across 13 studies of athlete populations (426 shoulders).<\/jats:p>\n                  <jats:p>CONCLUSION: Across studies with low- to very low\u2013certainty of evidence, the prevalence of RC imaging abnormalities in asymptomatic shoulders ranged from 0% to 100%. J Orthop Sports Phys Ther 2025;55(12):736-751. 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