The Evidence

Knee pain? 

• Research Article: Abnormal Findings on Knee Magnetic Resonance Imaging in Asymptomatic NBA Players

• Conclusion: 89% of asymptomatic knees showed abnormalities on MRI! "The Majority of professional basketball players have one or more abnormalities within their knee."

​Walczak BE et al.  Abnormal findings on knee magnetic resonance imaging in asymptomatic NBA players.  J Knee Surg.  2008;21:27-33.

• Research Article: Pitfalls in magnetic resonance imaging of the knee

• Conclusion: "The high prevalence of abnormal MR findings, especially meniscal tears with up to 63% on the asymptomatic contralateral side, has to be considered in patient management."

Zanetti M and Pfirrmann CW.  Pitfalls in magnetic resonance imaging of the knee.  Radiologe.  2006;46:71-77.

• Research Article: Magnetic Resonance Imaging of the Knee in Asymptomatic Professional Basketball Players

• Conclusion: "The results of our study show an equal to or higher prevalence of meniscal lesions in male professional basketball players than previously reported in the literature. We found a large number of patella-femoral articular cartilage lesions in our study population of male professional basketball players. These athletes perform at the highest demand level, which indicates that the presence of these lesions did not cause any symptoms."

Kaplan LD et al.  Magnetic resonance imaging of the knee in asymptomatic professional basketball players.  Arthroscopy.  2005;21:557-61.

​

Back Pain?

• Research Article: Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain

• Conclusion: "On MRI examination of the lumbar spine, many people without back pain have disk bulges or protrusions but not extrusions. Given the high prevalence of these findings and of back pain, the discovery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental."

Jensen MC, Brant-zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331(2):69-73.

• Research Article: MRI findings in the lumbar spines of asymptomatic, adolescent, elite tennis players

• Conclusion: "Abnormalities were frequent, predominately in the lower lumbar spine, almost exclusively at L4/5 and L5/S1 levels. Pars injuries and facet joint arthroses were relatively common."

Alyas F, Turner M, Connell D. MRI findings in the lumbar spines of asymptomatic, adolescent, elite tennis players. Br J Sports Med. 2007;41(11):836-41.

• Research Article: Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation

• Conclusion: "In the present study, about 30 per cent of an asymptomatic population had a major abnormality on a magnetic resonance image of the lumbar spine."

Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72(3):403-8.

• Research Article: The Value of Magnetic Resonance Imaging of the Lumbar Spine to Predict Low-Back Pain in Asymptomatic Subjects A Seven Year Follow Up Study

• Conclusion: "The findings on magnetic resonance scans were not predictive of the development or duration of low-back pain. Individuals with the longest duration of low-back pain did not have the greatest degree of anatomical abnormality on the original, 1989 scans."

Borenstein DG, O'mara JW, Boden SD, et al. The value of magnetic resonance imaging of the lumbar spine to predict low-back pain in asymptomatic subjects : a seven-year follow-up study. J Bone Joint Surg Am. 2001;83-A(9):1306-11.

​

Shoulder pain? 

• Research Article: Prevalence of abnormalities on shoulder MRI in symptomatic and asymptomatic older adults

• Conclusion: "Little association between clinical symptoms (shoulder pain and dysfunction) and the presence of pathology was shown in this study"

​Gill TK, Shanahan EM, Allison D, Alcorn D, Hill CL. Prevalence of abnormalities on shoulder MRI in symptomatic and asymptomatic older adults. Int J Rheum Dis. 2014;17(8):863-71.

• Research Article: High Prevalence of Superior Labral Tears Diagnosed by MRI in Middle-Aged Patients With Asymptomatic Shoulders

• Conclusion: "There is a high prevalence of superior labral tears diagnosed by MRI in the asymptomatic shoulders of middle-aged people. These findings suggest that superior labral tears noted by MRI may not be the cause of symptoms in this patient group with shoulder pain."

Schwartzberg R, Reuss BL, Burkhart BG, Butterfield M, Wu JY, Mclean KW. High Prevalence of Superior Labral Tears Diagnosed by MRI in Middle-Aged Patients With Asymptomatic Shoulders. Orthop J Sports Med. 2016;4(1):2325967115623212.

• Research Article: Ironman triathletes: MRI assessment of the shoulder

• Conclusion: "Partial thickness tears of the rotator cuff, rotator cuff tendinopathy, and AC joint arthrosis were common findings in both groups of triathletes.""No statistically significant difference was found among the findings for group 1, group 2, or the comparison group, although the difference between the comparison group and Ironman Triathletes approached statistical significance when evaluating for AC joint abnormal signal. Shoulder MRI of Ironman Triathletes should be interpreted with an appreciation of the commonly seen findings in asymptomatic subjects."

Reuter RM, Hiller WD, Ainge GR, et al. Ironman triathletes: MRI assessment of the shoulder. Skeletal Radiol. 2008;37(8):737-41.

• Research Article: Magnetic Resonance Imaging of the Asymptomatic Shoulder of Overhead Athletes

• Conclusion: "Magnetic resonance imaging alone should not be used as a basis for operative intervention in this patient population."

Connor PM, Banks DM, Tyson AB, Coumas JS, D'alessandro DF. Magnetic resonance imaging of the asymptomatic shoulder of overhead athletes: a 5-year follow-up study. Am J Sports Med. 2003;31(5):724-7.

Reuter RM, Hiller WD, Ainge GR, et al. Ironman triathletes: MRI assessment of the shoulder. Skeletal Radiol. 2008;37(8):737-41.

• Research Article: Magnetic Resonance Imaging Abnormalities in the Shoulder and Wrist Joints of Asymptomatic Elite Athletes

• Conclusion: "Asymptomatic elite athletes demonstrate MRI changes of the shoulder (swimmers and volleyball players) and wrist (gymnasts) similar to those associated with abnormalities for which medical treatment and sometimes surgery are advised. Given the somewhat high frequency of these asymptomatic findings, care must be taken to correlate clinical history and physical examination with MRI findings in these patients with symptoms."

Fredericson M, Ho C, Waite B, et al. Magnetic resonance imaging abnormalities in the shoulder and wrist joints of asymptomatic elite athletes. PM R. 2009;1(2):107-16.

​