Shoulder magnetic resonance imaging findings in patients with persistent shoulder pain after distal radius fracture: a multicenter pilot study

Purpose: Shoulder pain has been reported after distal radius fracture (DRF) and wrist immobilization, but the shoulder pathology underlying persistent symptoms after DRF remains poorly characterized. This study described shoulder magnetic resonance imaging (MRI) findings in patients with persistent ipsilateral shoulder pain after DRF.Methods: This multicenter retrospective pilot study reviewed medical records and shoulder MRI findings for patients who underwent ipsilateral shoulder MRI within 1 year after DRF. Demographic characteristics, history of shoulder symptoms, MRI findings, and treatment for shoulder pathology were evaluated. An exploratory subgroup analysis was performed in patients who underwent MRI within 3 months after DRF.Results: From January 2012 to August 2022, 24 patients underwent MRI of the ipsilateral shoulder within 1 year after a diagnosis of DRF. Of these, 23 had rotator cuff tears and 15 had adhesive capsulitis. Acromioclavicular joint arthritis was observed in 14 patients, and glenohumeral joint arthritis was observed in eight. Seven patients underwent MRI within 3 months after DRF.Conclusion: In this selected cohort of patients with shoulder pain after DRF, rotator cuff tears were the most frequently observed MRI finding. Most tears had features suggestive of chronic or degenerative pathology rather than acute traumatic injury. Adhesive capsulitis and shoulder arthritis were also frequent findings and may contribute to persistent shoulder symptoms after DRF. In conclusion, persistent ipsilateral shoulder pain after DRF should not be dismissed. In selected patients with persistent symptoms, clinicians should consider underlying shoulder pathology, including exacerbation or unmasking of preexisting degenerative disease.