Prevalence of MRI findings in adults with scapular pain: An exploratory cross-sectional study

Background Scapular pain has multiple possible pain generators including cervical radiculopathy, facet arthropathy, scapular dyskinesis, and myofascial pain making selecting an appropriate interventional target challenging. Magnetic resonance imaging (MRI) may be ordered as part of the workup, but the prevalence of imaging findings has not been reported. Objective To explore the prevalence of findings identified on MRI in patients with scapular pain. Methods This single-center exploratory cross-sectional study included adults presenting to orthopedic clinics from June 2015-June 2025 with scapular pain. Prevalence of MRI findings in the cervicothoracic spine, shoulder, and scapula were determined. Results 284 of 503 patients (56%) obtained at least one MRI: cervical spine (203), thoracic spine (76), shoulder (106), and scapula (22). The most prevalent findings were supraspinatus tendinopathy (88%), C5-6 foraminal stenosis (66%), and C5-6 degenerative changes (65%). Conclusions C5-6 pathology and supraspinatus tendinopathy were the most prevalent findings in patients with scapular pain. Incidental MRI findings in the spine and shoulder increase with age, and therefore MRI findings in patients with scapular pain should be cautiously interpreted within appropriate clinical context.